I-56: Value of 3D XI (Computed UltrasoundTomography) in the Evaluation of Benign ProstaticHyperplasia and Preservation of Men Infertility

The prevalence and incidence of clinical problems secondary to and associated with benign prostatic hyperplasia (BPH) have been increasing as the population ages. Men with lower urinary tract obstruction (LUTS) may have sexual dysfunction, including ejaculatory loss, painful ejaculation, and sometimes erectile dysfunction (ED). Even though, the pathogenic relationship between BPH and these symptoms is not completely understood. On the other hand, patients after TURP have a common complaint of retrograde ejaculation. Many reports have been produced by Watanabe (1998) and Ansari et al. (2000) describing the role of the surgical capsule as the main responsible for outlet stenosis and consequently the severity of LUTS. However, by 3D XI, transrectal computed ultrasound tomography (TRCUT) could allow for zonal description of the prostatic gland and consequently the accurate appreciation of BPH. By this technology, the “balance Principle” could be derived (Published in the international journal of urology, 2008), explaining the main reasons for BPH symptoms severity. Characterization of the container within the surgical capsule showed that the BPH nodular balance and type alongside the prostatic urethra are the main factors that impulse and responsible for symptoms severity. In other words, the clinical symptoms of BPH are primarily dependent upon the nodular imbalance effect upon the prostatic urethra.This principle has proved valuable in therapeutic purpose; to regain the urethral midline balance via TRCUTguided trans-perineal injection of the BPH nodules. Our aim is to appraise the value of 3D XI in the evaluation of prostates of aging men and accurately manage the less-invasive treatment for BPH. In other words to avoid retrograde ejaculation, transperineal injection of BPH nodules can preserve the male fertility and correct the balance alongside the prostatic urethra, preserving efficient antegrade ejaculation.