https://imcjms.com/public Ibrahim Medical College Journal of Medical Science https://imcjms.com/public/registration/journal_full_text/196 Thu, 20 Apr 2017 11:02:08 +0000 Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Address for Correspondence:Dr. Rukshana Ahmed, Lecturer, Department of Anatomy, Dhaka Medical College, Dhaka-1000, Bangladesh. E-mail: rukshanakahmed@yahoo.com   The prostate is partly glandular; partly fibro muscular organ.1 It is the largest accessory sex gland in the male reproductive system.2 It produces a thin milky fluid containing citric acid and acid phosphatase that is added to the seminal fluid at the time of ejaculation.3 Pathological process in prostate gland occurs commonly in association with aging and includes inflammation, atrophy, hyperplasia and carcinoma.4 Estimation of volume of prostate may be useful in a variety of clinical settings. For example, a precise estimate of the amount of BPH would help to determine the appropriate therapy as well as assist in the interpretation of serum prostate specific antigen (PSA) levels for the presence of cancer. Also the decrease in prostate mass after hormonal manipulation or radiation therapy can be used as an indicator of therapeutic efficacy.5 Also for PSA density determination accurate volume measurement is necessary.6 The effect of prostate volume on biopsy outcome was assessed and noted that there was an inverse relationship between the size of the gland and prostate cancer. When the gland size was less than 40 ml, 17 had prostate cancer and when more than 40 ml, only 7 were found to have prostate cancer. 7 The changes in prostate size i.e. volume are highly variable among aging men. Although benign prostatic hyperplasia with an increase in volume is very common, a considerable portion of aging men have a stable or decreasing prostate size.8 With the above perspectives, the volume of the prostate was thought to be of great value for diagnosis and treatment of various diseases of the prostate. As data on the volume of the prostrate in Bangladeshi males are scarce, this study was conducted, albeit on cadavers, to achieve the same. Materials & Methods   Volume of the prostate was measured by applying ellipsoid formula which requires measurement of three prostatic dimensions. Dimensions were first determined in the axial plane by measuring the transverse and antero-posterior dimensions at the estimated point of widest transverse dimension. The longitudinal dimension was measured in the sagittal plane. The ellipsoid volume formula10 was then applied as follows: The volumes were expressed in mean with standard deviation (SD) and comparison among the different age groups was made using ANOVA. The correlation coefficient was used to determine the association between age and volume of prostate. The SPSS version 11.0 was used. Results     Discussion   The present study showed the volume of the prostate according to the age group. It revealed – more is the age larger is the volume. The age group only over 40 years had a significantly larger prostate, indicating a significant increase in prostate size only in the aging male Bangladeshi population. Further studies may be undertaken in living humans with a view – a) to determine the prostate volume of different age group; b) to delineate the age when the prostate starts increasing in size and c) to identify the risk factors related to enlarged prostate both benign and malignant. Acknowledgement   1.   Sinnatamby CS. Last’s Anatomy: regional and applied. 11th ed. London: Elsevier Churchill Livingstone; 2006; 309-10. 3.   Snell RS. Clinical anatomy by regions. 8th ed. Baltimore: Lippincott Williams & Wilkins; 2008; 353-7. 5.   Terris MK, Stamey TA. Determination of prostate volume by transrectal ultrasound. J Urol 1991; 145: 984-7. 7.   Iqbal SA, Kumar RR, Beck R, Iacovou J. Prostate specific antigen (PSA) – to test or not to test. Bangladesh J Urology 2005; 8: 9-11. 9.   Begum S. An anatomical study of age changes of prostate in Bangladeshi people. (M.Sc. Thesis). Dhaka: IPGMR, University of Dhaka 1991; 37. 11.Moore RA. The evolution and involution of the prostate gland. Am J Path 1936; 12: 599-624. 13.Gearhart JP, Yang A, Leonard MP, Jeffs RD, Zerhouni EA. Prostate size and configuration in adults with bladder exstrophy. J Urol 1993; 149: 308-10. 15.Chicharro-Molero JA. Burgos-Rodriguez R. Sanchez-Cruz JJ, del Rosal-Samaniego JM, Rodero-Carcia P, Rodriguez-Vallejo JM. Prevalence of benign prostatic hyperplasia in spanish men 40 years old or older. J Urol 1998; 159: 878-82. 17.Overland GB, Vatten L, Rhodes T, DeMuro C, Jacobsen G, Vada K et al. Lower urinary tract symptoms, prostate volume and uroflow in Norwegian community men. Eur Urol 2001; 39: 36-41. 2026 Ibrahim Medical College. All rights reserved.