Binhan Kağan AKTAŞ, CEVDET SERKAN GÖKKAYA, Süleyman BULUT, Murat VURAL, Sedat YAHŞİ, Ali MEMİŞ

Benign prostat hiperplazili hastalarda prostat kalsifikasyonlarının alt üriner sistem semptomlarına etkisi

Amaç: Benign prostat hiperplazili BPH , transüretral prostat rezeksiyonu adayı, 40 yaş üzeri hastaları prostat kalsifikasyonu varlığına göre alt üriner sistem semptomları AÜSS ve diğer tanısal parametreler açısından ayrıntılı olarak değerlendirmek. Gereç ve Yöntem: AÜSS ile polikliniğimize başvuran 39 hasta çalışmaya dahil edildi. Hastaların tam idrar tetkiki, serum total ve serbest prostat spesifik antijen düzeyleri, üroflovmetrik ölçümleri, rezidü idrar miktarı tayini, kan üre ve kreatinin değerleri, transrektal ultrasonografide prostat hacimleri kaydedildi. Hastaların irritatif ve obstrüktif semptomları ayrı ayrı değerlendirilerek uluslar arası prostat semptom skoru IPSS: International prostate symptom score ve yaşam kalitesi skorları da ayrıca kaydedildi. Hastalara preoperatif pelvik bilgisayarlı tomografi BT çekilerek prostat hacimleri ile 3 noktadan anterior, posterior ve periferik prostatik dansite ölçümleri yapıldı ve ortalama prostatik dansiteleri hesaplandı. Pelvik BT’de >3mm prostatik kalsifikasyon olup olmaması kaydedildi. Otuz dokuz hastanın 15’inde %38.5 kalsifikasyon mevcutken, kalan 24’ünde %61.5 bulunmuyordu. Kalsifikasyon olanlar grup1, olmayanlar grup2 olmak üzere hastalar iki gruba ayrılarak, incelenen tüm parametreler açısından gruplar karşılaştırıldılar.Bulgular: Grup1’de grup2’ye göre Qmaks daha düşüktü p=0.039 ve sıkışma tipi inkontinans daha fazla görülmekteydi p=0.021 . İki grup arasında incelenen diğer tüm parametreler açısından anlamlı fark bulunmuyordu. Sonuç: Prostat kalsifikasyonu bulunan BPH hastalarında Qmaks düşmekte ve sıkışma tipi inkontinansa daha çok rastlanmaktadır. Bu hastalarda genel IPSS sorgulamasına ek olarak obstrüktif ve irritatif semptomların ayrı ayrı değerlendirilmesi daha yararlıdır

Anahtar Kelimeler:

Prostat kalsifikasyonu, benign prostat hiperplazisi, alt üriner sistem semptomları

The effect of prostatic calcifications over lower urinary tract symptoms in benign prostatic hyperplasia patients

Objective: To evaluate in detail, transurethral resection of prostate candidate, benign prostatic hyperplasia BPH patients over age 40 for lower urinary tract symptoms LUTS and the other diagnostic parameters according to the presence of prostatic calcifications.Materials and Methods: Thirty nine patients admitted to our clinic with LUTS were included in the study. A complete urinalysis, serum total and free prostate-specific antigen levels, uroflowmetric measurements, the amount of residual urine, blood urea and creatinine levels, transrectal ultrasound prostate volumes of the patients were recorded. International prostate symptom scores IPSS with separate irritative and obstructive symptom assessment and quality of life scores of patients were also recorded. Pre-operative pelvic computed tomography CT was performed, prostate volumes and prostatic densities at 3 points anterior, posterior, and peripheral were measured and the average densities were calculated. According to CT, prostatic calcifications over 3mm were recorded. Fifteen of 39 patients %38.5 had had prostatic calcification, while the remaining 24 %61.5 had not. Patients were divided into two groups; those with calcification group1 and those without group2. And two groups were compared in terms of all parameters examined.Results: In group1, Qmax was significantly lower p=0.039 and urge incontinence were more frequent p=0.021 than group2. Between the two groups studied there was no significant difference in all other parameters.Conclusion: Urge incontinence is more common and Qmax is lower in BPH patients with prostatic calcifications. Separate obstructive and irritative symptom assessment in addition to total IPSS is more informative in this group of patients

Keywords:

Prostatic calcification, benign prostatic hyperplasia, lower urinary tract symptoms,

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