Role of Transrectal Ultrasound in Assessing Disease Progression and Indications for Invasive Treatment in Benign Prostatic Hyperplasia.

Background: Transrectal ultrasound (TRUS) is a non-invasive and accurate imaging technique that plays a crucial role in evaluating the progression and pathological changes of benign prostatic hyperplasia (BPH). This study aimed to explore the relationship between TRUS parameters and BPH clinical progression, as well as the indications for invasive treatment, to provide more evidence for clinical decision making.

Methods: This retrospective study included 648 BPH patients diagnosed and treated in our hospital between January 2021 and October 2023. All patients underwent TRUS, and parameters including prostate volume (PV), transition zone volume (TZV), transition zone index (TZI), and intravesical prostatic protrusion (IPP) were recorded. Patients were followed for 1 year, and data on clinical progression and invasive treatment were collected. Univariate and multivariate regression analyses were performed to evaluate the predictive value of TRUS parameters for clinical progression and treatment selection.

Results: A total of 648 patients were included. During the 1-year follow-up, 75 patients experienced clinical progression, and 30 patients underwent invasive treatment. Univariate regression analysis revealed that TRUS parameters such as PV, TZV, and IPP were significantly associated with clinical progression and invasive treatment (p < 0.05). Multivariate regression analysis indicated that PV, TZV, and IPP were independent predictors of clinical progression, with an odds ratio (OR) of 1.114 (95% CI: 1.079-1.150) for PV, 1.062 (95% CI: 1.032-1.093) for TZV, and 1.427 (95% CI: 1.241-1.640) for IPP. Similarly, PV, TZV, and IPP were independent predictors for the occurrence of invasive treatment, with an OR of 1.064 (95% CI: 1.037-1.091) for PV, 1.030 (95% CI: 1.018-1.042) for TZV, and 1.135 (95% CI: 1.015-1.269) for IPP.

Conclusions: TRUS parameters can effectively predict the clinical progression and need for invasive treatment in BPH patients. Clinicians can use these parameters to develop more accurate and personalised treatment plans for patients.