Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited

Introduction: A lot of diagnostic tools are present for assessing the degree of LUTs. Pressure-flow studies are invasive and cannot be justified in all patients suffering from LUTs. From here came the clinical importance of searching for another clinical tool, to help in assessing the degree of LUTS...

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Main Authors: M. El Ghoneimy, M. Magdi, M. Abdel Rassoul, H. El Fayoumy, A. Abdel Hakim
Format: Article
Language:English
Published: SpringerOpen 2017-03-01
Series:African Journal of Urology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110570416300662
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author M. El Ghoneimy
M. Magdi
M. Abdel Rassoul
H. El Fayoumy
A. Abdel Hakim
author_facet M. El Ghoneimy
M. Magdi
M. Abdel Rassoul
H. El Fayoumy
A. Abdel Hakim
author_sort M. El Ghoneimy
collection DOAJ
description Introduction: A lot of diagnostic tools are present for assessing the degree of LUTs. Pressure-flow studies are invasive and cannot be justified in all patients suffering from LUTs. From here came the clinical importance of searching for another clinical tool, to help in assessing the degree of LUTS. Objective: The aim of this work was to evaluate the significance and clinical value of the TZI, which has been a point of debate over the last decade. Patients and methods: Between November 2011 and November 2012, sixty-two male patients above the age of 45 years were included in the study. They were divided into 3 groups (obstructed, retention and control groups). Assessment included IPSS, physical examination, DRE, labs, uroflowmetry, pressure flow studies, TRUS and a pelvic ultrasound for PVR. The transitional zone index (TZI) was calculated as being the transitional zone volume/whole gland volume ratio of the prostate. The whole gland volume, adenoma volume and TZI were compared in each group to each specific symptom, total IPSS, PSA, PdetQmax and Qmax. Results: No statistically significant correlation was found between the IPSS and the volume measurements, whether between the IPSS and whole gland volume or the IPSS and the TZV or TZI in the obstructed group and the control group. However, when dividing patients according to their TZI into two groups utilizing a TZI of 0.5 as a cutoff value, a possibility existed that patients might be more accurately classified into obstructed and non-obstructed. Conclusion: Estimating the transition zone volume during TRUS is a reasonable way to obtain the required information about the TZI. Calculating the TZI could not be directly correlated with any of the different parameters, making the clinical value of such an index questionable. The observation that the obstructed and the retention groups both had a TZI above 0.5 deserves further research that can help in the classification of patients into obstructed and non-obstructed.
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spelling doaj.art-6b7bb29960dc417095287b9185b413512022-12-21T17:57:00ZengSpringerOpenAfrican Journal of Urology1110-57042017-03-0123191310.1016/j.afju.2015.11.004Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: RevisitedM. El GhoneimyM. MagdiM. Abdel RassoulH. El FayoumyA. Abdel HakimIntroduction: A lot of diagnostic tools are present for assessing the degree of LUTs. Pressure-flow studies are invasive and cannot be justified in all patients suffering from LUTs. From here came the clinical importance of searching for another clinical tool, to help in assessing the degree of LUTS. Objective: The aim of this work was to evaluate the significance and clinical value of the TZI, which has been a point of debate over the last decade. Patients and methods: Between November 2011 and November 2012, sixty-two male patients above the age of 45 years were included in the study. They were divided into 3 groups (obstructed, retention and control groups). Assessment included IPSS, physical examination, DRE, labs, uroflowmetry, pressure flow studies, TRUS and a pelvic ultrasound for PVR. The transitional zone index (TZI) was calculated as being the transitional zone volume/whole gland volume ratio of the prostate. The whole gland volume, adenoma volume and TZI were compared in each group to each specific symptom, total IPSS, PSA, PdetQmax and Qmax. Results: No statistically significant correlation was found between the IPSS and the volume measurements, whether between the IPSS and whole gland volume or the IPSS and the TZV or TZI in the obstructed group and the control group. However, when dividing patients according to their TZI into two groups utilizing a TZI of 0.5 as a cutoff value, a possibility existed that patients might be more accurately classified into obstructed and non-obstructed. Conclusion: Estimating the transition zone volume during TRUS is a reasonable way to obtain the required information about the TZI. Calculating the TZI could not be directly correlated with any of the different parameters, making the clinical value of such an index questionable. The observation that the obstructed and the retention groups both had a TZI above 0.5 deserves further research that can help in the classification of patients into obstructed and non-obstructed.http://www.sciencedirect.com/science/article/pii/S1110570416300662ProstateBenign prostatic hypertrophyTransrectal ultrasonographyTransitional zone
spellingShingle M. El Ghoneimy
M. Magdi
M. Abdel Rassoul
H. El Fayoumy
A. Abdel Hakim
Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited
African Journal of Urology
Prostate
Benign prostatic hypertrophy
Transrectal ultrasonography
Transitional zone
title Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited
title_full Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited
title_fullStr Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited
title_full_unstemmed Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited
title_short Significance and clinical value of the transitional zone volume (TZV) or index (TZI) in assessing the degree of lower urinary tract obstruction: Revisited
title_sort significance and clinical value of the transitional zone volume tzv or index tzi in assessing the degree of lower urinary tract obstruction revisited
topic Prostate
Benign prostatic hypertrophy
Transrectal ultrasonography
Transitional zone
url http://www.sciencedirect.com/science/article/pii/S1110570416300662
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