Assessment of blood flow in the prostate before and after transuretral enucleation of benign hyperplasia prostate

Abstract

BACKGROUND: Transrectal Doppler ultrasound is the leading method for studying blood flow in the prostate. Despite a significant number of studies on the use of ultrasound of the prostate in patients with BPH, many aspects of its clinical use remain unclear. One of these issues is the features of changes in blood flow in the prostate after transurethral surgical interventions. AIM: to assess the state of blood flow in the prostate gland in patients with BPH before and after transurethral enucleation by laser and bipolar methods. MATERIALS AND METHODS: The study included 88 patients with BPH aged 50 to 79 years who complained of urinary disorders. All patients underwent transurethral enucleation of BPH: 41 patients with the laser method (HoLEP) (1st group) and 47 patients with the bipolar method (TUEB) (2nd group). Before surgical treatment, 4, 12 and 24 weeks after surgery, patients underwent transrectal Doppler ultrasound of the prostate. RESULTS: The results of the study indicate a significant impact of surgery on the state of blood flow in the prostate gland. Examination 12 weeks after the operation showed a significant decrease in the peak blood flow velocity and values of the resistance index in patients of the 1st and 2nd groups compared with the corresponding values before the surgery and 4 weeks after the surgery. By 24 weeks after surgery, all patients showed normalization of blood flow parameters, while in patients of the 1st group (HoLEP) this process occurred faster than in patients of the 2nd group (TUEB). CONCLUSIONS: The high diagnostic efficiency and informativeness of transrectal Doppler ultrasound in the assessment of blood circulation in the prostate in patients with BPH has been confirmed. The blood flow velocity in the subcapsular and especially paraurethral arteries, as well as the values of the resistance index, were higher in patients with large prostates, which must be taken into account when planning surgical interventions.