MP11-18 3D-ULTRASOUND ORIENTED ADJUSTMENT FOR SPHINCTERIC URETHRA PRIOR TO VELOCITY-FLOW EVALUATION USING DOPPLER ULTRASONOGRPAHY (2015)

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2015MP11-18 3D-ULTRASOUND ORIENTED ADJUSTMENT FOR SPHINCTERIC URETHRA PRIOR TO VELOCITY-FLOW EVALUATION USING DOPPLER ULTRASONOGRPAHY Hideo Ozawa, Michael Chancellor, Atsushi Nagai, and Hiromi Kumon Hideo OzawaHideo Ozawa More articles by this author , Michael ChancellorMichael Chancellor More articles by this author , Atsushi NagaiAtsushi Nagai More articles by this author , and Hiromi KumonHiromi Kumon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.399AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We have previous reported the potential utility of a noninvasive pressure-flow like urodynamic system based on the concept of Doppler sonography (J Urol 160,1787,1998). We hereby report advances in imaging and technology that allow successful measurement of urethral sphincteric velocities in all patients using 3D-ultrasound oriented adjustment prior to velocity-flow urodynamic study. METHODS Fifty men with voiding dysfunction underwent transperineal ultrasound urodynamics. Subjects were separated by prostatic volume more than 30cm3(BPE group: n=16) or less (Non obstructed group: n=34). The patient sat on a specially equipped chair. The ultrasound transducer (Prosound α6, Hitachi Aloka Med) was operated using robotic manipulator, and 3D-ultrasound volume rendered images were continuously obtained just before voiding. The anal canal, as a median reference point, set to the midline of the 3D image. After the function of the ultrasound machine turned from 3D to the Doppler measurement, then the Doppler images were recorded on the computer during voiding. The spatially averaged flow velocity curves were plotted on the computer screen. The velocities at the distal prostatic urethra (V1) and at the membranous urethra (V2) were obtained. RESULTS Using 3D-ultrasound oriented adjustment, velocity measurement of sphincteric urethra was successful in all cases except three (6%) where the patients could not hold micturition during panel operations necessary for the preparation. It was found that V1 (52.7cm/s) was larger than V2 (47.2cm/s) for the BPE group, whereas for non obstructed group V2 (63.4cm/s) was significantly larger than V1 (36.9cm/s). Since for most of the BPE patients prostatic urethra was the narrowest and the fastest part of the urethra, velocity decreased along the sphincter. But for normal men since sphincteric urethra was the narrowest, velocity increased along the sphincter. CONCLUSIONS The 3D ultrasonography helps to guide the adjustment of median sphincteric urethra prior to velocity flow study. Transperineal Doppler ultrasonography is a promising noninvasive diagnostic technique and provides a detailed analysis of voiding that may uniquely aid in assessing bladder outlet obstruction and overcome the present limitation of ultrasound equipment. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e126 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideo Ozawa More articles by this author Michael Chancellor More articles by this author Atsushi Nagai More articles by this author Hiromi Kumon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...