Evaluation of a new ultrasound measurement tool for the diagnosis of dysfunctional voiding in pediatric population: full/empty bladder wall thickness ratio.

OBJECTIVE: To investigate the roles of bladder wall thickness (BWT) measurement and full/empty (F/E) BWT measurement ratio in the diagnosis of dysfunctional voiding in pediatric population. METHODS: Totally, 324 patients were involved in this prospective study, and group 1 consisted of healthy children (n=198), and group 2 consisted of patients with dysfunctional voiding (n=126). BWT measurements were done at the anterior, posterior, and lateral walls, and F/E BWT ratios were calculated. Two groups were compared for BWT measurement, and receiver operating characteristic analysis was performed to find out a cutoff value for BWT and F/E BWT ratios. RESULTS: Mean age of group 1 was 6.4 years and that of group 2 was 6.5 years. BWT measurements were higher in the empty state compared with full state and in boys compared with girls. However, BWT ratios did not show significant difference between male and female patients. F/E BWT ratios were found to be higher in group 2 compared with group 1 (P=.02). In receiver operating characteristic analysis, a cutoff value of 0.324 (sensitivity 66.67% and specificity 79.80%) and 0.295 (sensitivity 83.33% and specificity 64.14%) was found for anterior and posterior F/E BWT rates, respectively. CONCLUSION: Ultrasonographic measurement of BWT and calculation of F/E BWT ratio may serve as a noninvasive tool for evaluating lower urinary tract symptoms in children. Further studies including larger number of patients would be of great interest.

Analysis of suprapubic and transrectal measurements in assessment of prostate dimensions and volume: is transrectal ultrasonography really necessary for prostate measurements?

INTRODUCTION: The objective of this study was to evaluate the correlation of suprapubic ultrasonography and transrectal ultrasonography in measurements of prostate dimension and volume. MATERIALS AND METHODS: One hundred consecutive patients with lower urinary tract symptoms were examined by suprapubic and transrectal ultrasonography modalities in a same session. Measurements of the 3 dimensions of the prostate (anteroposterior, transverse, and craniocaudal) and its volume performed by suprapubic ultrasonography were compared with the corresponding measurements by transrectal ultrasonography in order to determine the correlation of the measurements. Prostate volumes were calculated using the ellipsoid formula. Data were further analyzed in subgroups according to prostate volumes smaller or larger than 50 mL, measured by suprapubic ultrasonography. RESULTS: The mean prostate volume of the 100 patients, measured by suprapubic and transrectal ultrasonography were 65.9 +/- 35.8 mL and 62.5 +/- 32.0 mL, respectively (r = 0.94; P < .001). The craniocaudal diameters had the strongest correlation among dimension measurements (r = 0.89; P < .001). Suprapubic and transrectal ultrasonography measurements also showed significant correlations for both prostates smaller or larger than 50 mL. Eighty-five percent of the patients had both volume measurements under or above this limit. CONCLUSION: There was strong correlation between suprapubic and transrectal ultrasonography measurements of the prostate sizes, including both for volume or specific dimension measurements.

Effect of intralesional interferon-alpha 2b combined with oral vitamin E for treatment of early stage Peyronie's disease: a randomized and prospective study.

OBJECTIVES: To compare the efficacy and safety of intralesional interferon-alpha 2b combined with oral vitamin E or intralesional interferon-alpha 2b alone or oral vitamin E alone for the treatment of Peyronie's disease. METHODS: From January 2000 to March 2002, a total of 30 consecutive men with Peyronie's disease were randomized prospectively into three different treatment groups. All the patients were assessed objectively with penile duplex Doppler ultrasonography for plaque size, location, and presence of calcification before and after treatment. Subjective data were obtained by querying about the improvement in penile pain and by using the "global efficacy question" for the assessment of the quality of sexual intercourse at the end of the study. A total of 5.0 x 10(6) U of interferon-alpha 2b was given once per week directly into the plaque for a period of 12 weeks. Patients received 400 IU of vitamin E orally twice daily for 6 months. RESULTS: At the 6-month follow-up visit, we did not find any statistically significant changes in the objective parameters when compared with the initial findings in each group or among the three groups (P >0.05). We did not observe any clinically significant improvement in the subjective parameters among the three groups (P >0.05). However, all patients who were treated with interferon-alpha 2b experienced brief flu-like side effects. CONCLUSIONS: Our findings indicate that 5 million units of intralesional interferon-alpha 2b injection therapy either alone or in combination with vitamin E does not appear to be clinically effective in the management of early stage Peyronie's disease compared with only oral vitamin E.

Long-term results of Anderson-Hynes pyeloplasty in 180 adults in the era of endourologic procedures.

INTRODUCTION: The aim of the present study wasto evaluate the long-term results of adult open pyeloplasties performed by the Anderson-Hynes technique in the era of new endourologic procedures. MATERIALS AND METHODS: The medical records of 180 adult patients who underwent Anderson-Hynes pyeloplasty with a diagnosis of ureteropelvic junction (UPJ) obstruction, were retrospectively reviewed. Pre- and postoperative results were compared with clinical, radiologic and radionuclide studies. The mean age of the patients was 33.2 (16-65) years. The minimum clinical follow-up time was 12 months and the mean time from the operation was 9.4 years (between 1 and 17 years). RESULTS: Success was defined as resolution of symptoms and decrease in pyelocaliceal volume and calicectasis. The overall success rate was 91.1%. The success rate was between 93.1 and 100% in patients with grades I-III and 62.5% in patients with grade IV hydronephrosis and contribute to renal function less than 25%. The pyelocaliceal volume returned to normal in 39 (21.7%) patients, significantly decreased in 82 (45.5%), and the flow of contrast media from renal pelvis to ureter improved in 43 (23.9%) and did not change or increased in 16 (8.9%). The failure happened in the first 3 months in 57% of patients and in long-term follow-up in 43% of patients. CONCLUSION: Despite newer endoscopic techniques, Anderson-Hynes pyeloplasty, with an over 90% success rate remains the gold standard in the treatment of primary UPJ obstruction.