Transrectal Ultrasound Scanning Research Articles

Effect of delayed timing of artificial insemination with sex-sorted semen on pregnancy per artificial insemination in synchronized dairy heifers managed in a seasonal-calving pasture-based system

The objective of this study was to evaluate the timing of artificial insemination (AI) with frozen-thawed sex-sorted semen on pregnancy per AI (P/AI) in dairy heifers. A 6-d progesterone Co-Synch protocol was used for ovulation synchronization of dairy heifers, with timed AI (TAI) coincident with (TAI-0) or 8 h (TAI-8) after the second injection of GnRH, corresponding to either 48 h or 56 h after removal of the progesterone-releasing intravaginal device. Pregnancy diagnosis was conducted by transrectal ultrasound scanning of the uterus 34 d after TAI (n = 816 records available for analysis). Generalized linear mixed models were used to examine the effects of treatment on P/AI. Treatment (n = 2), herd (n = 11), and treatment × herd were included as categorical fixed effects. Heifer body weight and Economic Breeding Index values for milk production, fertility, calving performance, beef carcass, cow maintenance, cow management, and health were included as continuous fixed effects. Heifer ID was included as a random effect. Pregnancy per AI was greater for TAI-8 heifers (59%) compared with TAI-0 heifers (50%). Pregnancy per AI ranged from 38% to 75% between herds but there was no treatment × herd interaction. The fertility subindex (positive) and the cow management subindex (negative) were the only continuous animal variables associated with P/AI. Delaying the timing of AI with frozen-thawed sex-sorted semen by 8 h in dairy heifers enrolled on a 6-d progesterone Co-Synch protocol improved P/AI.

Effect of Stress on Ovarian Follicular Activity in Postpartum Sahiwal Cows during Hot-humid Season

Present investigation was carried out to study the effect of stress on ovarian follicular activity in postpartum acyclic Sahiwal cows during hot-humid months. Postpartum ovarian activity was monitored using trans-rectal ultrasound scanning on alternate days beginning between day 60 and 90 postpartum in Sahiwal cows (n=16) up to next 21 days.Daily maximum temperature and relative humidity was recorded andtemperature-humidity index (THI)was calculated during study period. Six animals (37.5 %) showed presence of dominant follicle (≥10 mm, cyclic) and 10 animals (62.5 %) were classified as acyclic (ovarian follicle < 10 mm diameter). Present study demonstrated that as the value of THI reduced, the mean follicular diameter proportionately increased and vice versa. Based on the findings of present study, it may be concluded that development of ovarian follicle is highly affected by THI value during hot-humid season in Sahiwal cows and the reproductive performance of animal may be predicted using THI values.

Quadruple Assessment using Transrectal Ultrasound Scan is Effective at Accurately Facilitating Choice of Excision Plane by Tems in the Complex Specc Lesion

Background: There is currently no consensus as to the optimal imaging modality for Significant Polyps and Early Colorectal Cancer (SPECC). This study describes the use of transrectal ultrasound (TRUSS) as part of a quadruple assessment process to evaluate the depth of invasion of SPECC lesions and guide local excision. Method: Pre-operative imaging and histology were reviewed for all patients undergoing transanal endoscopy microsurgery (TEMS) at Cheltenham General Hospital between 2013 and 2019. Treatment options included mucosectomy, partial thickness excision and full thickness excision. The dataset was studied specifically to evaluate the risk that malignancy will be present at the deep margin. ‘Failure’ of assessment was thus defined as the failure to detect and achieve complete local excision of malignancy. Results: 400 patients were included: 319 primary lesions and 81 secondary lesions. Amongst the primary lesions 93.7% (n=299) had successful R0 excisions. Of the primary lesions with incomplete excisions 50% (N=10) had undergone mucosectomy, 40% (n=8) full thickness excision and 10% (n=2) partial thickness excision

Correlation between Prostate Volume Estimated by Digital Rectal Examination and Trans-Rectal Ultrasound Measurements in Patients Diagnosed with Benign Prostatic Hyperplasia

Background: Measurement of Prostate Volume (PV) is fundamental in the proper management of patients with benign prostatic hyperplasia (BPH). Although a crude way of assessing PV, digital rectal examination (DRE) has been used in various centres and then objectified by the use of Transrectal Ultrasound Scan (TRUS) measurement for reasons of accuracy. Prostate volume measurement together with the use of international prostate symptom score (IPSS) is central in choosing treatment modalities whether medical or surgical. In this study, we aimed at correlating PV measured by DRE and TRUS. Patients and Methods: This is a prospective study of seventy four (74) patients being managed for BPH in our facility between September 2019 and December 2020 who met inclusion criteria. Full clinical history was obtained together with physical examination and well-focused DRE of the prostate to estimate PV based on Romero et al., technique combined with the sliding scale technique. Subsequently patients were sent for TRUS measurements of the prostate which is also a routine procedure in BPH managements. Data were collated and analysed using statistical package for social sciences (SPSS) version 20.0 Results: A total of 74 patients were studied with a mean age of 63.05±9.89 years ranging from 43 to 90 years. Mean PV estimated by DRE was 47.91±14.16 mls and that by TRUS was 53.42±25.33 mls. There was a statistically significant correlation in PV measurements between the two modalities (P v=.750, PV < .05). Conclusion: PV measured by DRE closely approximates TRUS measurements.

Short term ciprofloxacin and clindamycin combination antibiotic therapy before and after transrectal ultrasound scan and prostate biopsy: Its impact on major components of gut microbiome

The perturbation of gut microbiome is a risk factor for a number of adverse conditions. Among other factors antibiotic therapy is a common culprit. We characterized the short-term alteration of gut microbiome after antibiotic therapy.Nine patients (age (median [range]): 67 [57–75 years]) were subjected to prostate biopsy. Ciprofloxacin and clindamycin, 500 mg and 150 mg, respectively, were administered twice a day; this combination therapy was started the day before and continued until 5th and 8th day, respectively, following biopsy. 16s RNA sequencing data from fecal swabs taken before antibiotic therapy and 14 days after biopsy were analysed.At phylum level, the abundance of Actinobacteria and Firmicutes decreased, while that of Bacteroides and Proteobacteria increased after antibiotic therapy. The ratio of Firmicutes:Bacteroides inversed (from 2.81 to 0.74, p = 0.035). At order level, the abundance of Bacteroidales and Veillonellales increased, while that of Clostridiales and Coriobacteriales decreased. At genus level the abundance of Bacteroides increased, while those of Roseburia, Faecalibacterium and Collinsella decreased.These findings indicate that short-term antibiotic exposure skews gut microbiome composition. The current level of knowledge does not allow to decide whether this skewness is detrimental and has any long-term effect on disease including prostate pathology.

Correlation between prostate volume and prostate-specific antigen in Nigerian men with symptomatic histologically-diagnosed benign prostatic hyperplasia.

Prostate-specific antigen (PSA) is elevated in the serum of most men with prostatic diseases. Benign prostatic hyperplasia (BPH) is the commonest of these diseases. The degree of enlargement of the prostate may determine the amount of PSA elaborated. Several reports in some parts of the world have shown a significant correlation between prostate volume (PV) and PSA. However, only a few reports have been documented in Nigeria, especially in the South-South region. This research aimed to ascertain if there is any correlation between prostate volume (PV), total PSA (tPSA), and free PSA (fPSA) in men with histologically diagnosed BPH. This knowledge may help in the estimation of PV from a given PSA. This prospective hospital-based study was carried out in a southern Nigerian tertiary hospital between November 2017 and October 2018. Eighty (80) eligible and consenting patients participated in the study and were enrolled at first contact in the urology clinic. Each patient's blood was taken for PSA estimation. The prostate volume was estimated by transrectal ultrasound scan (TRUS). Those who had tPSA values greater than 4 ng/mL whose biopsy report showed prostate malignancy were excluded from the study. A proforma was used to collect patients' sociodemographic and clinical information. Data were entered and analyzed with Statistical Package for Social Sciences version 22 (SPSS Inc., Chicago, IL, United States). For all statistical tests, P < 0.05 was regarded as significant. The mean age of the patients for this study was 68.03 years. The mean prostate volume was 87.9 mL with a range of 34 to 234 mL. The mean tPSA was 5.5 ng/mL with ranges of 1.1 to 21.1 ng/mL. There was a significant correlation between PV and tPSA with a P value of 0.0001. This correlation was also shown between PV and fPSA with a P value of 0.0001. There is a statistically significant correlation between PV and PSA (both free and total) in men with symptomatic histologically diagnosed BPH. This finding showed that larger benign prostate glands elaborated greater amounts of PSA. It may, therefore, be appropriate to say that it is not in all cases of elevated serum tPSA that the possibilities of malignancy or inflammation should be entertained.

Malakoplakia of the prostate

Prostatic malakoplakia is a rare chronic inflammatory disease with only a few cases reported in the literature. It is believed to be caused by an impaired histiocytic response against bacteria. This is a case report of a 65-year-old man with a history of diabetes mellitus presenting with complaints of generalized weakness and fever of 4-day duration. Laboratory investigations showed pyuria, and urine culture showed Escherichia coli. An abdominal Computerised Tomography (CT) scan revealed left-sided pyelonephritis and a prostatic abscess. Double-J stenting with Trans-Rectal Ultrasound Scan (TRUS) biopsy was done. The biopsy showed features of malakoplakia of the prostate without any associated malignancy.

Sarcomatoid carcinoma of the prostate presenting as bilateral cervical lymphadenopathy: a rare case report

BackgroundSarcomatoid carcinoma (also called carcinosarcoma in the latest WHO classification 2016) of the prostate gland is a biphasic malignant neoplasm which exhibits epithelial and mesenchymal differentiation [1]. Sarcomatoid carcinoma is a rare tumour, considered as a variant of acinar adenocarcinoma in the WHO classification, with less than 200 reported cases in the literature to date [2]. Sarcomatoid carcinoma of prostate presenting with bilateral cervical lymph node deposits as the first clinical manifestation, is even rarer, and reported cases were not found in the literature; hence, this is the first case report of such, to the best of our knowledge.Case presentationWe report a case of sarcomatoid carcinoma of the prostate in a 72-year-old Sri Lankan man who presented with bilateral cervical lymphadenopathy. He had hard nodular prostate on digital rectal examination (DRE). Ultrasound scan of abdomen (USS) revealed the presence of paraaortic lymphadenopathy, in addition. The excision biopsy of the right cervical lymph node revealed deposit of a carcinoma of epithelioid histomorphology, which showed patchy strong positivity for immunohistochemical marker (IHCm), PSA. His serum PSA value was 48 ng/ml (reference < 5.40 ng/ml). Contrast-enhanced computed tomography (CECT) showed mildly enlarged prostate gland with irregular outline, sclerotic lesions in cervico-thoracic and lumbosacral vertebrae and generalized lymphadenopathy. Transrectal ultrasound guided biopsy of the prostate revealed sarcomatoid carcinoma. Disseminated sarcomatoid carcinoma of prostate was diagnosed. The patient has undergone bilateral orchidectomy, marking a serum PSA value of 5.4 ng/ml two months thereafter. He is surviving for six months after diagnosis and is currently under chemotherapy with docetaxel for the disseminated disease.ConclusionSarcomatoid carcinoma can present with cervical lymphadenopathy with absent lower urinary tract symptoms. In elderly patients with cervical lymphadenopathy, serum PSA, DRE and trans-rectal ultrasound scan are advocated to rule out prostate cancer. Immunohistochemical markers are required for the diagnosis of primary tumour and secondary deposit of sarcomatoid carcinoma of prostate.

Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

Background:Hematospermia, although often found to be a benign condition, can be an alarming sign. Consequently, patients can undergo multiple investigations with no current standardized pathway based on data from large series. The aim of this study was to evaluate the incidence of an underlying pathology and the value of diagnostic investigations performed in patients presenting with hematospermia.Materials and methods:A retrospective review of 393 consecutive men who underwent investigations for hematospermia was performed in a single tertiary center. Patient demographics, radiological and microbiological results were recorded together with symptoms of concomitant hematuria and clinical outcomes.Results:In this cohort, the overall prostate cancer detection rate was 5.3% and 7.2% in the ≥40 years group. One patient was diagnosed with testicular seminoma detected on scrotal ultrasound scan and one with G1pTa urothelial carcinoma of the bladder detected on flexible cystoscopy. In addition, 5.6% of patients were found to have a significant benign pathology for which intervention was proposed. A total of 288 patients underwent a transrectal ultrasound scan and 58.7% (n = 169) of these patients were found to have a positive finding. One hundred ten patients underwent a multiparametric magnetic resonance imaging and 73.6% (n = 81) had a positive finding.Conclusions:Apart from transrectal ultrasound and multiparametric magnetic resonance imaging, the remaining investigations have a low diagnostic yield. Prostate cancer detection was 5.3%; 7.2% in the ≥40 years group, and two further patients were diagnosed with testicular and bladder malignancy. Based on our results, we propose an algorithm for the management of hematospermia to limit unnecessary investigations with the majority requiring reassurance.

Prostatic Abscess: A Review and Update

Prostatic Abscess: A Review and Update

English

BACKGROUND Prostate is an associated gland of the male reproductive system. Worldwide, among the men, prostate cancer (PC) is the second most common cancer. PC is the seventh commonest cancers among the Indian male. Studies reported that diffusion weighted imaging (DWI) and dynamic contrast enhanced imaging (DCE-MRI), can offer additional value in localizing cancer. A study was conducted to evaluate and correlate the role of DWI in detection and staging of PC and correlation with histopathology. METHODS A cross-sectional observational study was conducted in the Department of Radiodiagnosis, GSL Medical College, over a period of 18 months. Males with symptoms of nocturia, urinary urgency, frequency, hesitancy and bone pain were included in the study. Trans rectal ultrasound scan (TRUS) biopsy was collected, Gleason‘s score (GS) was considered for the histopathologic analysis. The evaluation of DWI as a tool for detection of PC was based on comparing the sensitivity and specificity of the results after taking histopathology as the gold standard test chi-square test was used to find the statistical significance and P &lt; 0.05 was considered statistically significant. RESULTS Total, 36 (82 %) were diagnosed to be malignant, maximum number (18; 50 %) were between 61 – 70 years age group. Peripheral zone is the most common (61.2 %; 22) area for the PC followed by transitional (33.3 %) and central zone (5.5 %). In this study, 16.6 % members had GS ≤6; Apparent diffusion coefficient (ADC) was ranged between 0.81 to 0.87 and mean + SD were 0.85 + 0.02. Out of the 22.2 % members whose GS was 7, the mean + SD ADC were 0.74 ± 0.02. For 22 (61 %) members, GS was &gt;8; the mean + SD ADC was 0.63 ± 0.08; statistically there was significant difference between the parameters. Magnetic resonance imaging (MRI) revealed that 61.3 % (27) cases as highly suspicious, 25 % (11) as probably malignant and 13.6 % (6) as indeterminate; the sensitivity for MRI was 94.5 % and specificity was 85.7 %. CONCLUSIONS Patients with increased prostate specific antigen (PSA), multi-parametric magnetic resonance imaging (MPMRI) is valuable, non-invasive and a better option to detect PC. Also helps in localizing the exact location. KEYWORDS Cancer, Tumour, Biopsy, Study

PD11-02 PROSTATE INFLAMMATION AND COLLAGEN CONTENT ARE INVERSELY CORRELATED IN HUMAN BENIGN PROSTATIC HYPERPLASIA

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Basic Research & Pathophysiology (PD11)1 Sep 2021PD11-02 PROSTATE INFLAMMATION AND COLLAGEN CONTENT ARE INVERSELY CORRELATED IN HUMAN BENIGN PROSTATIC HYPERPLASIA Emily Serrell, Andrew Schneider, Matthew Grimes, Sijan Wang, and Wade Bushman Emily SerrellEmily Serrell More articles by this author , Andrew SchneiderAndrew Schneider More articles by this author , Matthew GrimesMatthew Grimes More articles by this author , Sijan WangSijan Wang More articles by this author , and Wade BushmanWade Bushman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001986.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate inflammation and fibrosis have been implicated in the development of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Mouse studies have shown prostate inflammation to produce tissue hyperplasia and an increase in prostatic collagen content (fibrosis). Here we examined the connections of inflammation, age, prostate volume (PV) and collagen content in human BPH surgical specimens. METHODS: Prostate tissue specimens were collected from patients treated by surgery for BPH/LUTS from 2005-2016. Patients were excluded if pathologic examination revealed >5% prostate cancer. PV was determined by transrectal ultrasound or pelvic CT scan. Collagen content was assessed by picrosirius red staining and digitally quantified. Inflammation was assessed by immunostaining with the pan-leukocyte marker CD45 and scored manually by a blinded observer. Associations between PV, age, collagen, and inflammation were evaluated by scatterplot analysis. RESULTS: In 53 men (mean age 65.1 (47-88)), the average PV was 65.5cc (47-88). Collagen content was positively correlated with age (0.34, p=0.01) but was negatively correlated with total inflammation score (r=-0.28, p=0.04). The correlations between increasing PV and both inflammation and collagen content were bimodal with a significant change point at 70 grams (p=0.002). For smaller prostates, inflammation increased (0.49, p=0.002) and collagen decreased (-0.35, p=0.03). For larger prostates, inflammation decreased (-0.29, p=0.30) and collagen increased (0.17, p=0.23). CONCLUSIONS: Our data reveal that age is a strong determinant of collagen content in BPH. In contrast to studies performed in mice, we found an inverse relationship between inflammation and collagen content. This difference may reflect different net effects of inflammation induced collagen degradation and synthesis in the dense stroma of the human prostate versus the more delicate stroma of the mouse. Finally, we found that small and larger prostates have a fundamentally different relationship to inflammation and collagen content, suggesting distinctive molecular or genetic mechanisms for prostate growth and inflammation. Source of Funding: VA Merit Award. I01 BX003454-01 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e197-e198 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Serrell More articles by this author Andrew Schneider More articles by this author Matthew Grimes More articles by this author Sijan Wang More articles by this author Wade Bushman More articles by this author Expand All Advertisement Loading ...

Transrectal Ultrasonography Findings in Cases of Premature Ejaculation

Transrectal Ultrasonography Findings in Cases of Premature EjaculationAbstract:Background:Premature ejaculation (PE) seems to be the most common sexual complaint in men. A prostatic inflammation is a knowncause of PE.Transrectal ultrasonography (TRUS) is widely used to help in the management of both benign and malignant diseases of the prostate. Aim of work:To discuss TRUS findings in cases of PE. Subjects and methods:A case control study carried out on 24 married adult male patients with age ranged from 25 to 53 years, diagnosed with PE, attending our outpatient clinic at the Department of Urology, Faculty of Medicine, Zagazig University Hospital for the first time from October 2018 to June 2019. Full medical history was taken from all patients. All patients underwent a complete andrological and physical examination.Evaluation of prostate and seminal vesicles was done via transrectal ultrasound scanning methods. Results:The TRUS findings of prostate showed that the volume of prostate among the studied cases ranged from 13.2 to 39.2 ml with mean 27.65 ml. 20.8% had calcification, 37.5% had inhomogeneous prostatic texture and only 4.2% had utricular cyst. The TRUS findings of seminal vesicle (SV) among the studied cases showed that total volume ranged from 4 to 9.5 ml with mean 6.55 ml. Conclusion:The TRUS of SV must be considered in the clinical assessment of patients with PE. SVs can be of a valuable target for the treatment of patients with PE and ultrasound changes in SV.

LRST model movable trevis: A novel method to restrain cattle in barns

Appropriate and humane method of restraining the animals is essential to perform any type of clinical examination especially during the use of modern diagnostic equipments like ultrasound scanner. Procedures involving repeated screening of more number of animals make it difficult to move them for restraining in fixed facilities like chute/trevis outside the barn. The ongoing research project on impact of thermal stress on fertility of cows involve ultrasound scanning, blood collection and other observations on many cows almost every day over a period of one year and necessitate repeated restraining. Hence, the idea of fabricating a convenient movable trevis to restrain cows within the barns was initiated and the final device developed through step by step improvisation was named as LRST model trevis. The trevis could be rolled within the barn to enclose the animal in its standing space and was fixed in situ using the facilities provided. The removable metal tray was used for placing the ultrasound scanner/other equipments in a safe and convenient position. The trevis on wheels was found to be very useful for transrectal ultrasound scanning and other procedures as it causes minimum stress to the animal, comfortable for the examiner, trouble free for the helpers, ensures safety and cleanliness of the machine, time saving and facilitates more effective diagnostic intervention. Hence, the LRST model movable trevis can be adopted with minor changes to suit individual farms for convenient handling and clinical examination especially ultrasound scanning of large ruminants within the barns.

A comparison of treatment planning techniques for low dose rate (LDR) prostate brachytherapy

Abstract Purpose The purpose of this study was to compare low-dose-rate prostate brachytherapy treatment plans created using three retrospectively applied planning techniques with plans delivered to patients. Methods and Materials Treatment plans were created retrospectively on transrectal ultrasound (TRUS) scans for 26 patients. The technique dubbed 4D Brachytherapy was applied, using TRUS and MRI to obtain prostatic measurements required for the associated webBXT online nomogram. Using a patient's MRI scan to create a treatment plan involving loose seeds was also explored. Plans delivered to patients were made using an intraoperative loose seed TRUS-based planning technique. Prostate V100 (%), prostate V150 (%), prostate D90 (Gy), rectum D0.1cc (Gy), rectum D2cc (Gy), urethra D10 (%), urethra D30 (%), and prostate volumes were measured for each patient. Statistical analysis was used to assess and compare plans. Results Prostate volumes measured by TRUS and MRI were significantly different. Prostate volumes calculated by the webBXT online nomogram using TRUS- and MRI-based measurements were not significantly different. Compared with delivered plans, TRUS-based 4D Brachytherapy plans showed significantly lower rectum D0.1cc (Gy) values, MRI-based 4D Brachytherapy plans showed significantly higher prostate V100 (%) values and significantly lower rectum D0.1cc (Gy), urethra D10 (%), and urethra D30 (%) values, and loose seed MRI-based plans showed significantly lower prostate V100 (%), prostate D90 (Gy), rectum D0.1cc (Gy), rectum D2cc (Gy), urethra D10 (%), and urethra D30 (%) values. Conclusions TRUS-based 4D Brachytherapy plans showed similar dosimetry to delivered plans; rectal dosimetry was superior. MRI can be integrated into the 4D Brachytherapy workflow. The webBXT online nomogram overestimates the required number of seeds.

Influence of Blood Metabolites on Ovarian Rebound in Postpartum Sahiwal Cows

Present investigation was carried out to study the influence of blood metabolites, viz., glucose and NEFA on ovarian rebound in postpartum Sahiwal cows. Advance pregnant Sahiwal cows (n=14) maintained at Bull Mother Experimental Farm at Anjora, Durg (CG), India were selected and divided into two Groups, Group I comprised of animals (n=7) with BCS ? 2.75 and that of Group II comprised of animals (n=7) with average BCS less than 2.75 at one week before parturition. Trans-rectal ultrasound scanning of ovaries was accomplished in animals of both groups on alternate days from 21 to 51 days postpartum to record the development of dominant follicles (DF). Animals of Group-I without DF recorded higher pre-partum BCS than those with DF (n=3). Non-significant differences were recorded in mean serum glucose concentration between animals of Group-I and Group-II during all days of observation. Significant differences were (p less than0.01) observed in mean serum glucose concentration between animals with and without DF of Group-I on day 20 postpartum (39.79±0.56 vs 43.53±0.29 mg/dl). Animals (n=3) with DF of Group-I showed significantly increasing trend of mean serum glucose level from 20 to 50 days of postpartum, whereas the animals (n=4) without DF recorded similar serum glucose levels between 10 and 40 days postpartum. Significantly (p less than 0.05) higher mean serum NEFA concentrations were recorded in animals without DF than in animals with DF of Group-I on all days from the day of calving to 50 days postpartum, except on day 10. It may be concluded that higher serum NEFA concentration influenced the development of dominant follicle in postpartum Sahiwal cows.

Correlation of prostate volume with severity of lower urinary tract symptoms as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia

BackgroundThe aim of the study is to find the correlation between the prostate volume and severity of lower urinary tract symptoms (LUTS) as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia (BPH).MethodsThe study was a prospective correlational study conducted between June 2016 and November 2017. A total of 290 patients who presented with LUTS suggestive of BPH and satisfied the inclusion criteria were consecutively recruited. Clinical evaluation including digital rectal examination of the prostate was done. Symptoms severity was assessed using the self-administered international prostate symptoms score (IPSS) questionnaire. Prostate volume was determined by transrectal ultrasound scan, and the urine flow rate was measured using uroflowmeter. Data were analyzed using SPSS version 20.0, and p value < 0.05 was taken to be statistically significant.ResultsThe mean age of the patients was 64.22 ± 9.04 years with a range of 40 to 95 years. Most of the patients had moderate symptoms (55%) on IPSS with the mean IPSS value of 16.41 ± 7.43. The mean Qmax value was 16.55 ± 7.41 ml/s, and the median prostate volume (IQR) was 45.05 (35, 59). There was a positive significant correlation between prostate volume and IPSS (r = 0.179, p = 0.002) and a negative significant correlation between prostate volume and Qmax (r = − 0.176, p = 0.003).ConclusionThis study showed a significant correlation between the prostate volume and IPSS, and also between prostate volume and maximum flow rate (Qmax).

A comparison of treatment planning techniques for low-dose-rate (LDR) prostate brachytherapy

PurposeThe purpose of this study was to compare low-dose-rate prostate brachytherapy treatment plans created using three retrospectively applied planning techniques with plans delivered to patients. Methods and MaterialsTreatment plans were created retrospectively on transrectal ultrasound (TRUS) scans for 26 patients. The technique dubbed 4D Brachytherapy was applied, using TRUS and MRI to obtain prostatic measurements required for the associated webBXT online nomogram. Using a patient's MRI scan to create a treatment plan involving loose seeds was also explored. Plans delivered to patients were made using an intraoperative loose seed TRUS-based planning technique. Prostate V100 (%), prostate V150 (%), prostate D90 (Gy), rectum D0.1cc (Gy), rectum D2cc (Gy), urethra D10 (%), urethra D30 (%), and prostate volumes were measured for each patient. Statistical analysis was used to assess and compare plans. ResultsProstate volumes measured by TRUS and MRI were significantly different. Prostate volumes calculated by the webBXT online nomogram using TRUS- and MRI-based measurements were not significantly different. Compared with delivered plans, TRUS-based 4D Brachytherapy plans showed significantly lower rectum D0.1cc (Gy) values, MRI-based 4D Brachytherapy plans showed significantly higher prostate V100 (%) values and significantly lower rectum D0.1cc (Gy), urethra D10 (%), and urethra D30 (%) values, and loose seed MRI-based plans showed significantly lower prostate V100 (%), prostate D90 (Gy), rectum D0.1cc (Gy), rectum D2cc (Gy), urethra D10 (%), and urethra D30 (%) values. ConclusionsTRUS-based 4D Brachytherapy plans showed similar dosimetry to delivered plans; rectal dosimetry was superior. MRI can be integrated into the 4D Brachytherapy workflow. The webBXT online nomogram overestimates the required number of seeds.

Evaluation of delayed timing of artificial insemination with sex-sorted sperm on pregnancy per artificial insemination in seasonal-calving, pasture-based lactating dairy cows

The objective was to use ovulation synchronization with timed artificial insemination (TAI) to evaluate the effect of timing of artificial insemination (AI) with frozen sex-sorted sperm on fertility performance in pasture-based compact calving herds. Ejaculates from 3 Holstein-Friesian bulls were split and processed to provide frozen sex-sorted sperm (SS) at 4 × 106 sperm per straw, and frozen conventional sperm at 15 × 106 sperm per straw (CONV). A modified Progesterone-Ovsynch protocol was used for estrous synchronization, with TAI occurring 16 h after the second GnRH injection for cows assigned to CONV, and either 16 h (SS-16) or 22 h (SS-22) for cows assigned to SS. Pregnancy diagnosis was conducted by transrectal ultrasound scanning of the uterus 35 to 40 d after TAI (n = 2,175 records available for analysis). Generalized linear mixed models were used to examine the effects of treatment on pregnancy per artificial insemination (P/AI). Fixed effects included treatment (n = 3), bull (n = 3), treatment by bull interaction, parity (n = 4), days-in-milk category (n = 3), and treatment by days-in-milk category, with herd (n = 24) included as a random effect. Pregnancy per AI was greater for CONV compared with both SS-16 and SS-22 (61.1%, 49.0%, and 51.3%, respectively), and the SS treatments did not differ from each other (relative P/AI for SS-16 and SS-22 vs. CONV were 80.2% and 84.0%, respectively). There were significant bull and treatment by bull interaction effects. Additional analysis was undertaken using a model that included herd as a fixed effect. This analysis identified marked herd-to-herd variation (within-herd relative P/AI for the combined SS treatments vs. CONV ranged from 48-121%). The tertile of herds with the best performance achieved a mean relative P/AI of 100% (range = 91-121%), indicating that P/AI equivalent to CONV is achievable with SS. Conversely, the tertile of herds with the poorest performance achieved a mean relative P/AI of 67% (range = 48-77%). We found that SS resulted in poorer overall P/AI compared with CONV sperm regardless of timing of AI. Marked variation existed between herds; however, one-third of herds achieved P/AI results equal to CONV. Identification of factors responsible for the large herd-to-herd variation in P/AI with SS, and development of strategies to reduce this variation, warrant further research.

Improvement of Embryo Recovery in Holstein Cows Treated by Intra-Ovarian Platelet Rich Plasma before Superovulation.

The current research was designed to evaluate if intra-ovarian administration of autologous platelet rich plasma (PRP) before superovulation could increase the number of follicles responsive to gonadotropin treatment in order to improve embryo recovery in donor cows. Eight Holstein-Friesian cows of proven fertility were employed. After estrous synchronization, at the 18th day of diestrous, the right ovary of each cow was left untreated and served as control while the left ovary was inoculated with 5 mL of PRP. Cows were left to spontaneously return to estrous, and nine days later, a standard superovulation was initiated for every cow. Seven days after artificial insemination (AI), putative embryos were collected by flushing the right and left uterine horns separately. All statistics were calculated by ANOVA. The mean number of follicles, evaluated by transrectal ultrasound scanning, did not statistically differ before PRP treatment between right (control) and left (treated) ovaries (9.18 ± 1.35 and 7.32 ± 1.67, p = 0.28, respectively) as well as at 48 h after PRP injection (7.67 ± 2.52 and 8.00 ± 2.00, p = 0.73, respectively). A statistical (p = 0.023) difference was found in the average number of follicles at the last gonadotropin injection between control and treated ovaries (11.33 ± 2.89 and 20.00 ± 9.17, respectively). The statistically different (p = 0.0037) number of grade 1-2 blastocysts harvested from the uterine horn ipsilateral to control ovaries in comparison to that collected from the treated ones (6.63 ± 2.92 and 14.75 ± 5.92, respectively) suggests that intra-ovarian injection of PRP before superovulation could exert beneficial effects both in latent follicle growth and in vivo embryo production.