COMPARISON OF ULTRASOUND IMAGING IN PATIENTS UNDERGOING TRANSPERINEALAND TRANSRECTAL PROSTATE ULTRASOUND

Objectives. Prostatic evaluation in men who have undergone prior abdom inoperineal resection pose an unusual challenge for the urologist. Nei ther digital rectal examination nor transrectal ultrasound (TRUS) can be performed. Transperineal ultrasound (TPUS) has been suggested as an alternative means of imaging. This imaging modality was compared dire ctly with the standard TRUS method. Methods. TPUS was performed with a 4-MHz abdominal probe or biplane multiple frequency probe at a freque ncy of 5 to 7 MHz followed by TRUS at 7 MHz in 50 consecutive men refe rred for prostate ultrasound and biopsy who had not undergone prior ab dominoperineal resection. Dimensions of the prostate and ultrasound fi ndings such as hypoechoic, anechoic, or hyperechoic areas were noted f or each sonographic approach. Volume calculation was performed by the prolate spheroid method. Results. There was good TPUS visualization of the prostate in the transverse plane in 48 (96%) of 50 patients and i n the sagittal plane in 45 (90%) of 50 patients. Prostate volume calcu lation by TPUS correlated well with the volume calculated by TRUS (r = 0.876). Twenty-nine patients (58%) were found to have suspicious hypo echoic lesions by TRUS; none were seen by TPUS. Prostatic calcificatio ns were present in 12 patients and were visualized by both TPUS and TR US in all 12 patients. Six prostate glands demonstrated cystic lesions on TRUS imaging; three of these cystic lesions were also seen with TP US imaging. Conclusions. TPUS allows visualization of the prostate wit h volume determination that is comparable to the volume determination by TRUS. Some intraprostatic findings such as calcifications and cysts can be identified; however, suspicious hypoechoic lesions were not id entified by TPUS imaging of the prostate. (C) 1998, Elsevier Science I nc. All rights reserved.