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APPLICATION OF WASSERMAN CLASSIFICATION ON BENIGN PROSTATIC HYPERPLASIA ON MRI
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Abstract
Purpose: Benign prostatic hyperplasia was a common health problem in older men because it can cause bladder outlet obstruction (obstructive urinary symptoms). The purpose of this study was to apply the Wasserman classification of benign prostatic hyperplasia on MRI in a group of patients. Material and Methods: A retrospective descriptive study on 25 male patients who visited Hanoi Medical University Hospital from February 2019 to May 2022 due to high total PSA and/or urination disorder. All patients underwent prostate multi-parametric MRI and transrectal ultrasound guided biopsy with the histopathological result of benign prostatic hyperplasia. Prostate parameters including total prostate volume, transition zone volume, total PSA, density PSA, and transitional density PSA were documented. Benign prostatic hyperplasia was identified on axial, sagittal and coronal MRI images and was classified into 7 categories according to Wasserman. Results: A total of 25 patients with benign prostatic hyperplasia were identified by histopathology. The median (interquartile range) of age, prostate volume, transition zone volume, total PSA, density PSA and transitional density PSA of the patient group were 68 (64-71.5), 64 cm3 (40-83.5 cm3), 48.3 cm3 (30.5-73 cm3), 13.4 ng/ml (9.1-20.2 ng/ml), 0.17 ng/ml/cm3 (0.11-0.39 ng/ml/cm3) and 0.27 ng /ml/ cm3 (0.14-0.57 ng/ml/ cm3), respectively. According to Wasserman classification, there were 01 type 0 (prostate volume ≤ 25 cm3 with no or little enlargement); 08 type 1 (bilateral transition zone hypertrophy); 05 type 2 (post-urethral hypertrophy); 07 type 3 (simultaneously bilateral and retro-urethral transitional hypertrophy); No case of type 4 (hypertrophy with one or more peduncles); 01 type 5 (with peduncle with bilateral transitional hypertrophy and/or retro-urethral hypertrophy); 02 type 6 (hypertrophy in the area below the cervical triangle or ectopic hypertrophy) and 01 type 7 (combinations of zonal enlargement). Conclusion: The Wasserman classification of benign prostatic hyperplasia by MRI has high value to assess the correlation with clinical signs, thereby planning appropriated treatment for patients depending on the type of benign prostatic hyperplasia.
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