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Significance of resistive index of prostatic arteries in diagnosis of BPH

Benign prostatic hyperplasia (BPH) is predominantly found in middle-aged and elderly men and is often associated with lower urinary tract symptoms (LUTS).1

Transrectal ultrasonography is recommended by the Korean Prostate Society as an option for the assessment of BPH. However, power Doppler transrectal ultrasonography (PDUS) allows visualisation of the prostatic vasculature and has improved the diagnosis of BPH.1

A prospective study of 110 patients with BPH and LUTS recently published in the International Neurourology Journal evaluated the relationships between clinical features of BPH and resistive indexes (RI) of the capsular and urethral arteries of the prostate measured using PDUS.1

Patients were grouped based on:

  • International Prostate Symptom Score (0–7 mild; 8–19 moderate; 20–35 severe
    symptoms)
  • Maximal flow rate (Qmax) (<10 and ≥10 mL/sec)
  • Total prostate volume (TPV) (<30 and ≥30 mL)
  • Presence/absence of intravesical prostatic protrusion (IPP).1


RI in the prostatic arteries measured by PDUS correlated with increased prostate size and presence of IPP. 1

The mean RIs of the urethral artery and the left and right capsular arteries were significantly dependent on TPV and presence of IPP. 1However, no significant relationship between RI and IPSS or Qmax was found for any prostatic artery. 1

The mean RIs of the urethral artery and the left and right capsular arteries were significantly dependent on TPV and presence of IPP. 1Further studies are required to investigate a potential change in RIs in response to surgical or pharmacological treatment of BPH. 1

Reference list

  1. Kwon SY, Ryu JW, Choi DH, Lee KS. Clinical significance of the resistive index of prostatic blood flow according to prostate size in benign prostatic hyperplasia. Int Neurourol J 2016; 20(1): 75-80.