Lower urinary tract symptoms in men with prostatic enlargement may or may not be associated with bladder outlet obstruction (BOO). Also, BOO suggestive benign prostatic hyperplasia (BPH) is a common disease in elder men. The present golden standard diagnostics, however, is an invasive method, named pressure-flow studies. The purposes of the thesis are to develop non-invasive procedures for diagnosing obstruction.
Prostate volume is a frequently used, non-invasive variable, but the present methods are not able to be accurately measured. Thus, one of the aims of the study was to propose an eccentricity parameter (EP index) based correction to the ellipsoid formula to improve the evaluation of the prostate volume defined by transabdominal ultrasonography (TAUS) at different stages of benign prostatic hyperplasia. By applying the correction formula, the mean prostate volume differences of TAUS with computed tomography (CT) were improved from 27.0%, -23.9%, and 0.8% to 6.2%, -3.2%, and 0.8% for EP < 0.055, 0.055 < EP < 0.14, and EP > 0.14, respectively. Hence, for EP > 0.14, representing the advanced stage of BPH, TAUS with the ellipsoid formula can be regarded as an effective tool for computing volume; while for EP < 0.14, the correction formula is recommended to improve the volume estimation based on TAUS.
The study was also to investigate how apex-localizing methods and the slice-thickness affected the CT based prostate volume estimation. Interobserver variations to locate the bottom of ischial tuberosities (ITs) and the bulb of the penis were, on average, 0.10 cm (range: 0.03 to 0.38 cm) and 0.30 cm (range: 0.00 to 0.98 cm), respectively. The range of slice-thickness varied from 0.08 to 0.48 cm was adopted to examine the influence of the variation on volume estimation. The volume deviation from the reference case (0.08 cm), which increases in tandem with the slice thickness, was within ±3 cm3, regardless of the adopted apex-locating reference positions. In addition, the maximum error of apex identification was 1.5 times of slice thickness. These results will help to identify factors that affect prostate volume calculation and to contribute to the improved estimation of the prostate volume based on the CT images.
After correcting prostate volume estimations, the study investigates the development of an index, named PVQ, which combines prostate volume and maximum free uroflow rate as a reliable predictor of obstruction. The formula of PVQ index was, (15/ Q)×(PV/30), where the values of 15 (mL/sec) and 30 (cm3) are the threshold values for Q and PV, respectively. A PVQ value of 1 was an accurate metric for the determination of BOO that corresponded to a BOO index of 20 to the following extent: accuracy 93%, sensitivity 96%, specificity 80%, PPV 96%, NPV 80% and kappa 0.76. The PVQ parameter outlined in this article can differentiate obstruction in the majority of men with LUTS and it is in nearly complete agreement with the BOO Index. Therefore, this metric is suggested as an early predictor of obstruction. If an individual's measurements correspond to a PVQ > 1, we suggest that he undergoes further intensive testing.
Finally, the study also develops a non-invasive procedure, which combines computational fluid dynamics and the medical imaging techniques, as a novel approach for diagnosing BOO. Based on the computed tomography images, the lower urinary tract system is reconstructed. The flow resistance within the urinary tract is predicted using the computational fluid dynamics. It is shown that this quantity displayed a high correlation (r: 0.86) with the golden standard parameter, BOO index, i.e., clinically measured data for patients with BOO. This indicates that the present method may be potentially valid substitute for invasive BOO index.

1. Aarnink RG, Beerlage HP, de la Rosette JJ, Debruyne FM, Wijkstra H. Transrectal ultrasound of the prostate: innovations and future applications. J Urol 1998; 159: 1568-1579.
2. Aarnink RG, de la Rosette JJMCH, Huynen AL, Giesen RJB, Debruyne FMJ, Wijkstra H. Standardized assessment to enhance the diagnostic value of prostate volume; part 1: morphometry in patients with lower urinary tract symptoms. Prostate 1996; 29: 317-326.
3. Abrams P. Objective evaluation of bladder outlet obstruction. BJU Int, 1995; 76: 11-15.
4. Abrams P. Urodynamics, 1997; second edition. London: Springer.
5. Abrams P, Griffiths D. The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br J Urol 1979; 51: 129-134.
6. Abrams P. Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int 1999; 84: 14-15.
7. Algano, Hanks GE, Shaer AH. Localization of the prostatic apex for radiation treatment planning. Int J Radiat Oncol Biol Phys 1995; 33: 925-930.
8. Al-Qaisieh B, Ash D, Bottomley DM, Carey BM. Impact of prostate volume evaluation by different observers on CT-based post-implant dosimetry. Radiother Oncol 2002; 62: 267-273.
9. Artibani W. Integrating the patient risk profile in the management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Eur Urol Suppl 2004; 3: 1-6.
10. AUA practice guideline committee. AUA guidelines on management of benign prostatic hyperplasia. Chapter 1: Diagnosis and treatment recommendations. J Urol 2003; 170: 530-547.
11. Babaian RJ, Fritsche HA, Evans RB. Prostate-specific antigen and prostate gland volume. Correlation and clinical application. J Clin Lab Anal 1990; 4: 135-138.
12. Badiozamani KR, Wallner K, Cavanagh W, Blasko J. Comparability of CT-based and TRUS-based prostate volumes. Int J Radiat Oncol Biol Phys 1999; 43: 375-378.
13. Barry MJ, Cockett AT, Holtgrewe HL, McConnell JD, Sihelnik SA, Winfield HN. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 1993; 150: 351-358.
14. Barry MJ, Fowler FJ Jr, O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett ATK. The American Urological Association Symptom Index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992; 148: 1549-1557.
15. Barry MJ, Girman CJ, O'Leary MP et al. Using repeated measures of symptom score, uroflowmetry and prostate specific antigen in the clinical management of disease: Benign Prostatic Hyperplasia Treatment Outcomes Study Group. J Urol 1995; 153: 99-103.
16. Bazinet M, Karakiewicz PI, Aprikian AG, Trudel C, Peloquin F, Dessureault J, Goyal M, Begin LR, Elhilali MM. Reassessment of nonplanimetric transrectal ultrasound prostate volume estimates. Urology 1996; 47: 857-862.
17. Belal M, Abrams P. Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 1: Nonurodynamic approach. J Urol 2006; 176: 22-28.
18. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol 1984; 132: 474.
19. Berthelet E, Liu MCC, Agranovich A, Patterson K, Currie T. Computed tomography dtermination of prostate volume and maximum dimensions: a study of interobserver variability. Radiother Oncol 2002; 63: 37-40.
20. Bitter MS, Bender M, McDonnell KT, Kaufman A, Wan M. Ceasar: A smooth, accurate and robust centerline extraction algorithm. Proc of Visualization 2000; 539: 45-52.
21. Blaivas JG. Multichannel urodynamic studies in men with benign prostatic hyperplasia: indications and interpretation. Urol Clin North Am 1990; 17: 543-552.
22. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 8: 307-310.
23. Bohnen AM, Groeneveld FP, Bosch JLHR. Serum prostate-specific antigen as a predictor of prostate volume in the community: the Krimpen study. Eur Urol 2007; 51: 1645-1653.
24. Boormans JL, van Venrooij GEPM, Boon TA. Invasively estimated international continence society obstruction classification versus noninvasively assessed bladder outlet obstruction probability in treatment recommendation for LOTS suggestive of BPH. Urology 2007; 69: 485-490.
25. Brindley G, Craggs M. The effect of atropine on the urinary bladder of the baboon and of man. J Physiol 1975; 256: 55.
26. Brocklehurst JC. Urinary incontinence in the community. Analysis of a MORI poll. Br Med J 1993; 306: 832-834.
27. Bross S, Braun PM, Michel MS, Juenemann KP, Alken P. Bladder wall tension during physiological voiding and in patients with an unstable detrusor or bladder outlet obstruction. BJU Int 2003; 92: 584-588.
28. Chancellor MB, Rivas DA, Keeley FX, Lotfi MA, Gomella LG. Similarity of the American Urological Association Symptom Index among men with benign prostatic hyperplasia (BPH), urethral obstruction not due to BPH and detrusor hyperreflexia without outlet obstruction. Br J Urol 1994; 74: 200.
29. Chang C, Liu CH, Lin CA. Boundary conditions for lattice Boltzmann simulations with complex geometry flows. Comput Math Appl 2009; 58: 940-949.
30. Chen S, Doolen GD. Lattice Boltzmann method for fluid flow. Annu Rev Fluid Mech 1998; 30: 329-364.
31. Chen SY, Chen HD, Martinez D, Matthaeus W. Lattice Boltzmann model for simulation of magnetohydrodynamics. Phys Rev Lett 1991; 67: 3776-3779.
32. Chenven ES, Glazier DB, Krisch EB, Diamond SM, Marmar JL. Evalation of prostate volume by transrectal ultrasonography for use in a brachytherapy program. Urology 2001; 58: 752-755.
33. Chia SJ, Heng CT, Chan SP, Foo KT. Correlation of intravesica prostatic protrusion with bladder outlet obstruction. BJU Int 2003; 91: 371-374.
34. Ching YT, Lin CY, Tan KC, Lau KL, Yang CH, Lin CA. Rectangular Meshes Construction of The Human Urethra Using 3D GVF Snakes. Proc of SPIE 2004; 5369: 539-549.
35. Chung JS, Byun SS, Han BK, Jeong SJ, Hong SK, Lee SE. Changes in prostate-specific antigen levels and prostate volume in octogenarian men: community-based study. Urology 2009; 73: 1270-1273.
36. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, Lieber MM. The prevalence of prostatism: a population based survey of urinary symptoms. J Urol 1993; 150: 85-89.
37. Cohen RJ, Shannon BA, Phillips M, Moorin RE, Wheeler TM, Garrett KL. Central zone carcinoma of the prostate gland: a distinct tumor type with poor prognostic features. J Urol 2008; 179: 1762-1767.
38. Comiter CV, Sullivan MP, Schacterle RS, Yalla SV. Prediction of prostatic obstruction with a combination of isometric detrusor contraction pressure and maximum urinary flow rate. Urology 1996; 48: 723-730.
39. Corica FA, Jacobsen SJ, King BF, Bostwick DG, Jacobson DJ, Girman CJ, Lieber MM. Prostatic central zone volume, lower urinary tract symptom severity and peak urinary flow rates in community dwelling men. J Urol 1999; 161: 831-834.
40. DeLacey G, Johnson S, Mee D. Prostatism: how useful is routine imaging of the urinary tract? Br Med J 1988; 296: 965-967.
41. Cvitkovic-Kuzmic A, Brkljacic B, Ivankovic D. Sonographic measurement od detrusor muscle thickness in healthy children. Pediatr Nephrol 2001; 16: 1122-1125.
42. Cvitkovic-Kuzmic A, Brkljacic B, Ivankovic D et al. Ultrasound assessment of detrusor muscle thickness in children with non-neurogenic bladder/sphincter dysfunction. Eur Urol 2002; 41: 214-219.
43. de la Rosette JJ, Witjes WP, Schafer W, Abrams P, Donovan JL, Peters
TJ et al. Relationship between lower urinary tract symptoms and bladder outlet obstruction: results from the "ICS-BPH" study. Neurourol Urodyn 1998; 17: 99.
44. Denis L, McConnell J, Yoshida O et al. The evaluation and treatment of lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction. Proceeding of 4th International Consultation on BPH 1998: 669-684.
45. Ding YY, Lieu PK. Comparison of three methods of quanitifying urethral resistance in men. Urology 1998; 52: 858-862.
46. Donker PJ, Kakiailatu F. Preoperative evaluation of patients with bladder outlet obstruction with particular regard to excretory urography. J Urol 1978; 120: 685-686.
47. Donovan JL, Kay HE, Peters TJ, Abrama P, Coast J, Matos-Ferreira A, Rentzhog L, Bosch JL, Nording J, Gajewski JB, Barbalias G, Schick E, Silva MM, Nissenkorn I, de la Rosette JJ. Using the ICSQoL to measure the impact of lower urinary tract symptoms on quality of life: evidence from the ICS-'BPH' study. International Continence Society - Benign Prostatic Hyperplasia. Br J Urol 1997; 80: 712-721.
48. Drach GW, Layton TN, Binard WJ. Male peak urinary flow rate: relationship to volume voided and age. J Urol 1979; 122: 210-214.
49. Drinnan MJ, Robson W, Reddy M, Pickard RS, Ramsden PD, Griffiths CJ. Transmission of penile cuff pressure to the penile urethra. J Urol 2001; 166: 2545-2549.
50. Drinnan MJ, Johnston A, Macdonald AM, Pickard RS, Ramsden PD, Griffiths CJ. Comparison of bladder pressure, urethral pressure and cuff pressure during interruption of flow by inflation of a penile cuff. Neurourol Urodyn 2001; 20: 384-386.
51. Drinnan MJ, Pickard RS, Ramsden PD, Griffiths CJ. Assessment of prostatic obstruction: A cuff may be enough. Neurourol Urodyn 2003; 22: 40-44.
52. Eckhardt MD, van Venrooij GEPM, Boom TA. Symptoms, prostate volume, and urodynamic findings in elderly male volunteers without and with LUTS and in patients with LUTS suggestive of benign prostatic hyperplasia. Urology 2001; 58: 966-971.
53. Ei-Hakim A, Elhilali M. Office management of benign prostatic enlargement. Canadian J CME 2001.
54. Eri LM, Thomassen H, Brennhovd B, H\o{a}heim LL. Accuracy and repeatability of prostate volume measurements by transrectal ultrasound. Prostate Cancer Prostatic Dis 2002; 5: 273-278.
55. Eri LM, Wessel N, Berge V. Test-retest variation of pressure flow parameters in men with bladder outlet obstruction. J Urol 2001; 165: 1188-1192.
56.
Ezz El Din K, Kiemeney LALM, De Wildt MJAM, Debruyne FMJ, De La Rosette JJMCH. Correlation between uroflowmetry, prostate volume, postvoid residue, and lower urinary tract symptoms as measured by the international prostate symptom score. Urology 1996; 48: 393-397.
57. Fiorino C, Reni M, Bolognesi A, Cattaneo GM, Calandrino R. Intra- and inter-observer variability in contouring prostate and seminal vesicles: implications for conformal treatment planning. Int J Radiat Oncol Biol Phys 1998; 47: 285-292.
58. Franciosi M, Koff WJ, Rhoden EL. Correlation between the total volume, transitional zone volume of the prostate, transitional prostate zone index and lower urinary tract symptoms (LUTS). Int Urol Nephrol 2007; 39: 871-877.
59. Garzotto M, Hudson RG, Peters L, Hsieh YC, Barrera E, Mori M, Beer TM, Klein T. Predictive modeling for the presence of prostate carcinoma using clinical, laboratory, and ultrasound parameters in patients with prostate specific antigen levels 10 ng/mL.
Cancer 2003; 98: 1417-1422.
60. Gerber RL, Smith AR, Owen J, Hanlon A, Wallace M, Hanks G. Patterns of care survey results: treatment planning for carcinoma of the prostate. Int J Radiat Oncol Biol Phys 1995; 33: 803-808.
61. Gloi A, McCourt S, Zuge C, Goettler AD, Schlise S, Cooley G. A Bland-Altman analysis of the bias between computed tomography and ultrasound prostate volume menasurements. Med Dosim 2008; 33: 234-238.
62. Griffiths CJ, Rix D, MacDonald AM, Drinnan MJ, Pickard RS, Ramsden PD. Non-invasive measurement of bladder pressure by controlled inflation of a penile cuff. J Urol 2002; 167: 1344-1347.
63. Griffiths CJ, Harding C, Blake C, McIntosh S, Drinnan MJ, Robson WA et al. A nomogram to classify men with lower urinary tract symptoms using urine flow and noninvasive measurement of bladder pressure. J Urol 2005; 174: 1323-1326.
64. Griffiths D, Hofner K, van Mastrigt R, Rollema HJ, Sp\o{a}ngberg A, Gleason D. Standardization of terminology of lower urinary tract function: pressure-flow studies of voiding, urethral resistance and urethral obstruction. International Continence Society Subcommittee on Standardization of Terminology of Pressure-Flow Studies. Neurourol Urodyn 1997; 16: 1-18.
65. Griffiths DJ, van Mastrigt R, Bosch R. Quantification of urethral resistance and bladder function during voiding, with special reference to the effects of prostate size reduction on urethral obstruction due to benign prostatic hyperplasia. Neurourol Urodynam 1989; 8: 29-52.
66. Guo ZL, Zheng CG, Shi BC. Discrete lattice effects on the forcing term in the lattice Boltzmann method. Phys Rev E2002; 046308.
67. Hakenberg OW, Linne C, Manseck A, Writh MP. Bladder wall thickness in normal adults and men with mild lower urinary tract symptoms and benign prostatic enlargement. Neurourol Urodyn 2000; 19: 585-593.
68. Hansen F, Olsen L, Atan A, Nordling J. Pressure-flow studies: Short-time repeatability. Neurourol Urodyn 1999; 18: 205-214.
69. Harding C, Robson W, Drinnan M, McIntosh S, Sajeel M, Giffiths CJ, Pickard R. The penile cuff test: A clinically useful non-invasive urodynamic investigation to diagnose men with lower urinary tract symptoms. Indian J Urol 2009 ;25: 116-121.
70. Ho CF, Chang C, Lin KH, Lin CA. Consistent boundary conditions for 2D and 3D lattice Boltzmann simulations. CMES-Comp Model Eng Sci 2009; 44: 137-155.
71. Hochberg DA, Armenakas NA, Fracchia JA. Relationship of prostate-specific antigen and prostate volume in patients with biopsy proven benign prostatic hyperplasia. Prostate 2000; 45: 315-319.
72. Hoffelt SC, Marshall LM, Garzotto M, Hung A, Holland J, Beer TM. A comparison of CT scan to transrectal ultrasound-measured prostate volume in untreated prostate cancer. Int J Radiat Oncol Biol Phys 2003; 57: 29-32.
73. Homma Y, Kawabe K, Tsukamoto T, Yamanaka H, Okada K, Okajima E, Yoshida O, kumazawa J, Gu FL, Lee C, Hsu TC, de la Cruz RC, Tantiwang A, Lim PH, Sheikh MA, Bapat SD, Marshall VR, Tajima K, Aso Y. Epidemiologic survey of lower urinary tract symptoms in Asia and Australia using the International Prostate Symptom Score. Int Urol 1997; 4: 40-46.
74. Huang Foen Chung JWNC, de Vries SH, Raaijmakers R, Postma R, Bosch JLHR, van Mastrigt R. Prostate volume ultrasonography: The influence of transabdominal versus transrectal approach, device type and operator. Eur Urol 2004; 46: 352-356.
75. Inui E, Ochiai A, Naya Y, Ukimura O, Kojima M. Comparative morphometric study of bladder detrusor between patients with benign prostatic hyperplasia and controls. J Urol 1999; 161: 827.
76. Isaacs JT, Coffey DS. Etiology and disease process of benign prostatic hyperplasia. Prostate 1989: 33-50.
77. Isikay L, Akgul KT, Nuhoglu B, Ozdemir G, Ayyildiz A, Cavumirza T, Germiyanoglu C. Lower urinary tract symptoms, prostate volume, uroflowmetry, residual urine volume and bladder wall thickness in Turkish men: a comparative analysis. Int Urol Nephrol 2007; 39: 1131-1135.
78. Jacobsen SJ, Chute CG, Girman CJ, Oesterling JE, Guess HA, Lieber MM, Panser LA. Do prostate size and urinary flow rates predict health care-seeking behavior for urinary symptoms in men? Urology 1995; 45: 64-69.
79. Jacobsen SJ, Girman CJ, Guess HA, et al. Natural history of prostatism. Longitudinal changes in voiding symptoms in community dwelling men. J Urol 1996; 155: 595-599.
80. Jepsen JV, Bruskewitz RC. Comprehensive patient evaluation for benign prostatic hyprtplasia. Urology 1998; 51: 13-18.
81. Jequier S, Rousseau O. Sonographic measurements of the normal blaader wall in children. AJR Am J Roentgenol 1987; 149: 563-566.
82. Johnston H, Hiits M, Beckham W, Berthelet E. 3D ultrasound for prostate localization in radiation therapy: A comparison with implanted fiducial markers. Med Phys 2008; 35: 2403-2413.
83. Kagawa K, Lee WR, Schultheiss TE, Hunt MA, Shaer AH, Hanks GE. Initial clinical assessment of CT-MRI image fusion software in localization of the prostate for 3D conformal radiation therapy. Int J Radiat Oncol Biol Phys 1997; 38: 319-325.
84. Kalkner KM, Kubicek G, Nilsson J, Lundell M, Levitt S, Nilsson S. Prostate volume determination: differential volume measurements comparing CT and TRUS. Radiother Oncol 2006; 81: 179-183.
85. Kanao K, Kikuchi E, Nakashima J, Horiguchi Y, Nakagawa K, Oya M, Ohigashi T, Marumo K, Murai M. Three-dimensional ultrasonography in evaluation of benign prostatic hyperplasia. Int J Urol 2004; 11: 1087-1091.
86. Kaplan SA, Ikeguchi EF, Santarosa RP et al. Etiology of voiding dysfunction in men less than 50 years of age. Urology 1996; 47: 836-839.
87. Kass M, Witkin A, Terzopoulox D. Snakes: Active Contour Models. Int J Comput Vis 1987; 1: 321-331.
88. Kessler TM, Gerber R, Burkhard FC. Ultrasound assessment of detrusor thickness in men: Can it predict bladder outlet obstruction and replace pressure flow study? J Urol 2006; 175: 2170-2173.
89. Kim SH and Kim SH. Correlations between the various methods of estimating prostate volume: transabdominal, transrectal, and three-dimensional US. Korean J Radiol 2008; 9: 134-139.
90. Kobayashi T, Kawahara T, Nishizawa K, Ogura K, Mitsumori K, Ide Y. Value of prostate volume measurement using transabdominal ultrasonography for the improvement of prostate-specific antigen-based cancer detection. Int J Urol 2005; 12: 881-885.
91. Kojima M, Inui E, Ochiai A, Naya Y, Ukimura O, Watanabe H. Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: A preliminary report. Urology 1996; 47: 942-947.
92. Kojima M, Inui E, Ochiai A, Naya Y, Ukimura O, Watanabe H. Noninvasive quantitative estimation of infravesical obstruction using ultrasonic measurement of bladder weight. J Urol 1997; 157: 476-479.
93. Kojima M, Ochiai Atsushi, Naya Y, Ukimura O, Watanabe M, Watanabe H. Correlation of presumed circle area ratio with infravesical obstruction in men with lower urinary tract symptoms. Urology 1997; 50: 548-555.
94. Kortmann BB, Sonke GS, Wijkstra H, Nordling J, Kallestrup E, Holm NR, de La Rosette JJ. Intra- and Inter-investigator variation in the analysis of pressure-flow studies in men with lower urinary tract symptoms. Neurourol Urodyn 2000; 19: 221-232.
95. Kuo HC. Transition zone index of the prostate as an indicator of bladder outlet obstruction and predictor of response to medical treatment in symptomatic benign prostatic hyperplasia. Tzu Chi Med J 1997; 9: 249-258.
96. Kuo HC. Clinical prostate score for diagnosis of bladder outlet obstruction by prostate measurements and uroflowmetry. Urology 1999; 54: 90-96.
97. Laguna P, Alivizatos G. Prostate specific antigen and benign prostatic hyperplasia. Curr Opin Urol 2000; 10: 3-8.
98. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174.
99. Laniado ME, Ockrim JL, Marronaro A, Tubaro A, Carter SS. Serum prostate-specific antigen to predict the presence of bladder outlet obstruction in men with urinary symptoms. Br J Urol 2004; 94: 1283-1286.
100. Larsen EH, Bruskewitz RC. Urodynamic evaluation of male outflow obstruction. Krane RJ, Siroky B eds. Clinical Neurourol 1991; 427-443.
101. Launder BE, Spalding DB. The numerical computation of turbulent flows. Comp Meth in Appl Mech and Eng 1974; 269-289.
102. Lee C, Cockett A, Cussenot K, Griffiths K, Isaacs W, Schalken. Regulation of Prostate Growth. In: Proceedings of the Fifth International Consultation on Benign Prostatic Hyperplasia. Edited byChatelain C, Denis L, Foo KT, Khoury S, McConnell J. United Kingdom: Health Publications Ltd., chapt 3, 79-106, 2001.
103. Lee SE, Chung JS, Han BK, Moon KH, Hwang SI, Lee HJ, Choe G, Hong SK. Relationship of prostate-specific antigen and prostate volume in Korean men with biopsy-proven benign prostatic hyperplasia. Urology 2008; 71: 395-398.
104. Liao CC, Chang YW, Lin CA, McDonough JM. Simulating flows with moving rigid boundary using immersed boundary method. Comput Fluids 2009; 39: 152-167.
105. Lien FS, Chen WL, Leschziner MA. A multiblock implementation of a non-orthogonal, collocated finite volume algorithm for complex turbulent flows. Int J Numer Meth Fluids 1996; 23: 567-588.
106. Lim CS, Abrams P. The Abrams-Griffiths nomogram. World J Urol 1995; 13: 34-39.
107. Lim KB, Ho H, Foo KT, Wong MYC, Fook-chong S. Comparison of intravesical prostatic protrusion, prostate volume and serum prostatic-specific antigen in the evaluation of bladder outlet obstruction. Int J Urol 2006; 13: 1509-1513.
108. Loeb S, Han M, Roehl KA, Antenor JAV, Catalona WJ. Accuracy of prostate weight estimation by digital rectal examination versus transrectal ultrasonography. J Urol 2005; 173: 63.
109. Lohner R, Cebral J, Soto O, Yim P, Burgess JE. Applications of patient-specific CFD in medicine and life sciences. Int J Numer Meth Fluids 2003; 43: 637-650.
110. MacMahon PJ, Kennedy AM, Murphy DT, Maher M, McNicholas MM. Modified prostate volume algorithm improves transrectal US volume estimation in men presenting for prostate brachytherapy. Radiology 2009; 250: 273-280.
111. Madersbacher S, Klingler HC, Djavan B, et al. Is obstruction predictable by clinical evaluation in patients with lower urinary tract symptoms? BJU Int 1997; 80: 72-77.
112. Manieri C, Carter SS, Romano G, Trucchi A, Valenti M, Tubaro A. The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness. J Urol 1997; 159: 761-765.
113. Matthews GJ, Motta J and Fracchia JA. The accuracy of transrectal ultrasound prostate volume estimation: Clinical correlations. J Clin Ultrasound 1996; 24: 501-505.
114. McNeal JE. Origin and evolution of benign prostatic enlargement. Invest Urol 1978; 15: 340.
115. McRae LP, Bottaccini MR, Gleason DM. Noninvasive quantitative method for measuring lsovolumetric bladder pressure and urethral resistance in the male: 1. Experimental validation of the theory. Neurourol Urodyn 1995; 14: 101-114.
116. Meyhoff HH, Ingemann L, Nordling J, Hald T. Accuracy in preoperative estimation of prostate size. A comparative evaluation of rectal palpation, intravenous pyelography, urethral closure pressure profile recording and cystourethroscopy. Scand J Urol Nephrol 1981;15: 45.
117. Michel MC, Mehlburger L, Schumacher H, Bressel HU, Goepel M. Effect of diabetes on lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Urol 2000; 163: 1725-1729.
118. Milosevic M, Voruganti S, Blend R, Alasti H, Warde P, McLean M, Catton P, Catton C, Gospodarowicz M. Magnetic resonance image (MRI) for localization of the prostate apex: comparison to computed tomography (CT) and urethrography. Radiother Oncol 1998; 47: 277-284.
119. Mochtar CA, Kiemeney LALM, van Riemsdijk MM, Baenett GS, Laguna MP, Debruyne FMJ, de la Rosette JJMCH. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia. Eur Urol 2003; 44: 695-700.
120. Morote J, Encabo G, L?pez M, de Torres IM. Prediction of prostate volume based on total and free serum prostate specific antigen: is it reliable? Eur Urol 2000; 38: 91-95.
121. Narayana V, Roberson PL, Winfield RJ, McLaughlin PW. Impact of ultrasound and computed tomography prostate volume registration on evaluation of permanent prostate implants. Int J Radiat Oncol Biol Phys 1997; 39: 341-346.
122. Nathan MS, Seenivasagam K, Mei Q, Wickham JEA, Miller RA. Transrectal ultrasonography: why are estimates of prostate volume and dimension so inaccurate? Br J Urol 1996; 77: 401-407.
123. Naya Y, Kojima M, Honjyo H, Ochiai A, Ukimura O, Watanabe H. Intraobserver and interobserver variance in the measurement of ultrasound-estimated bladder weight. Ultrasound Med Biol 1998; 24: 771-773.
124. Neal DE, Styles RA, Powell PH, Thong J, Ramsden PD. Relationship between voiding pressure, symptoms and urodynamic finding in 253 men undergoing prostatectomy. Br J Urol 1987; 60: 554.
125. Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol 2005; 7: S14-S21.
126. Nose H, Foo KT, Lin KB, Yokoyama T, Ozawa H, Kumon H. Accuracy of two noninvasive methods of diagnosing bladder outlet obstruction using ultrasonography: intravesical prostatic protrusion and velocity-flow video urodynamics. Urology 2005; 65: 493-497.
127. Ockrim JL, Laniado ME, Patel A, Tubaro A, Carter SSC. A probability based system for combining simple office parameters as a predictor of bladder outflow obstruction. J Urol 2001; 166: 2221-2225.
128. Oelke M, Hofner K, Wiese B, Gr\"{u}newald V, jonas U. Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. Worid J Urol 2002; 19: 443-452.
129. Oelke M, Hofner K, Jonas U, Ubbink D, de la Rosette JJ, Wijkstra H. Ultrasound measurement of detrusor wall thickness in healthy adults. Neurouro Urodyn 2006; 25: 308-317.
130. Oelke M, Hofner K, Jonas U, de la Rosette JJ, Ubbink DT, Wijkstra H. Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume. Eur Urol 2007; 52: 827-835.
131. Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, Lieber MM. Serum prostate specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges. JAMA 1993; 270: 860-864.
132. Ohnishi K, Watanabe H, Ohe H, Saitoh M. Development and clinical significance of protrusion of hypertrophic prostate into the bladder observed by transrectal ultrasonotomography. Nippon Hinyokika Gakkai Zasshi 1985; 76: 1194.
133. Ozawa H, Chancellor MB, Ding YY, Nasu Y, Yokoyama T, Kumon H. Noninvasive urodynamic evaluation of bladder outlet obstruction using Doppler ultrasonography. Urology 2000; 56: 408-412.
134. Ozawa H, Igarashi T, Uematsu K, Watanabe T, Kumon H. The future of urodynamics: Non-invasive ultrasound videourodynamics. Int J Urol 2010; 17: 241-249.
135. Park SB, Kim JK, Choi SH, Noh HN, Ji EK, Cho KS. Prostate volume measurement by TRUS using heights obtained by transaxial and midsagittal scanning: comparison with specimen volume following radical prostatectomy. Korean J Radio 2000; 1: 110-113.
136. Patankar SV, Spalding DB. Calculation procedure for heat, mass and momentum transfer in three-dimensional parabolic flows. Int J Heat Mass Transfer 1972; 15: 1787-.
137. Pel JJM, van Mastrigt R. Devlopment of a CFD urethral model to study flow-generated vortices under different conditions of prostatic obstruction. Physiol Meas 2007; 28: 13-23.
138.
Plants BA, Chen DT, Fiveash JB, Kim RY. Bulb of penis as a marker for prostatic apex in external beam radiotherapy of prostate cancer. Int J Radiat Oncol Biol Phys 2003; 56: 1079-1084.
139. Qian YH, d'Humieres D, Lallemand P. Lattice BGK model for Navier-Stokes equation. EPL 1992; 17: 479-484.
140. Reynard JM, Abrams P. Bladder outlet obstruction assessment of symptoms. World J Urol 1995; 13: 3.
141. Reynard JM, Peters TJ, Lamond E, Abrams P. The significance of abdominal straining in men with lower urinary tract symptoms. Br J Urol 1995; 75: 148.
142. Reynard JM, Lim C, Abrams P. Significance of intermittency in men with lower urinary tract symptoms. Urology 1996; 47: 491.
143. Reynard JM, Yang Q, Donovan JL, et al. The ICS-'BPH' Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction. BJU Int 1998; 82: 619-623.
144. Roach III M, Faillace-akazawa P, Malfatti C, Holland J. Prostate volumes defined by magnetic resonance imaging and computerized tomogrphic scans for three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 1996; 35: 1011-1018.
145. Roach III M, Pickett B, Holland J, Zapotowski KA, Marsh DL, Tatera BS. The role of the urethrogram during simulation for localized prostate cancer. Int J Radiat Oncol Biol Phys 1993; 25: 299-307.
146. Rodriguez E, Skarecky D, Narula N, Ahlering TE. Prostate volume estimation using the ellipsoid formula consistently underestimates actual gland size. J Urol 2008; 179: 501-503.
147. Roehrborn CG. Accurate determination of prostate size via digital rectal examination and transrectal ultrasound. Urology 1998; 51: 19-22.
148. Roehrborn CG, Girman CJ, Rhodes T, Hanson KA, Collins GN, Sech SM, Jacobsen SJ, Garraway WM, Lieber MM. Correlation between prostate size estimated by digital rectal examination and measured by transrectal ultrasound. Urology 1997; 49: 548-557.
149. Roehrborn CG, Boyle P, Gould AL, Waldstreicher J. Serum prostate specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia. Urology 1999; 53: 581-589.
150. Roehrborn CG, Sech S, Montoya J, Rhodes T, Girman CJ. Interexaminer reliability and validity of a three-dimensional model to assess prostate volume by digital rectal examination. Urology 2001; 57: 1087-1092.
151. Roehrborn CG, McConnell JD. Etiology, pathophysiology, epidemiology and natural history of benign prostatic hyperplasia. In Campbell's Urology 2002. Edited by Walsh PC, Retik AB, Vaughan ED, Wein Jr AJ. Philadelphia PA: Saundera WB Company, chapt 38: 1297-1330.
152. Sajadi KP, Terris MK, Hamilton RJ, Cullen J, Amling CL, Kane CJ, Presti JC, Aronson WJ, Freedland SJ. Body mass index, prostate weight and transrectal ultrasound prostate volume accuracy. J Urol 2007; 178: 990-995.
153. Sandler HM, Bree RL, McLaughlin PW, Grossman HB, Lichter AS. Localization of the prostatic apex for radiation therapy using implanted markers. Int J Radiat Oncol Biol Phys 1993; 27: 915-919.
154. Sarma AV, Mclaughlin JC, Jacobsen SJ, et al. Longitudinal changes in lower urinary tract symptoms among a cohort of black American men: the Flint Men's Health Study. Urology 2004; 64: 959-965.
155. Sauver JLS, Jacobson DJ, Girman CJ, McGree ME, Lieber MM, Jacobsen SJ. Correlations between longitudinal changes in transitional zone volume and measures of benign prostaic hyperplasia in a population-based cohort. Euro Urol 2006; 50: 105-111.
156. Siroky MB, Olsson CA, Krane RJ. The flow rate nomogram: development (I). J Urol 1979; 122: 665-668.
157. Schafer W. The contribution of the bladder outlet to the relation between pressure and flow rate during micturition. In: Hinman, F Jr, Boyarsky, S, eds. Benign Prostatic Hypertrophy. New York, NY: Springer Verlag 1983; 470-496.
158. Schafer W. Urethral resistance? Urodynamic concepts of physiological and pathological bladder outlet function during voiding. Neurourol Urodyn 1985; 4: 161-201.
159. Schafer W. Basic principles and clinical application of advanced analysis of bladder voiding function. Urol Clin N Am 1990; 17: 553-566.
160. Schafer W. Urodynamics of micturition. Curr Opin Urol 1992; 2: 252-256.
161. Schafer W. Analysis of bladder oulet function with the linearized passive urethral resistance relation, linPURR, and a disease-specific approach for grading obstruction: from complex to simple. World J Urol 1995; 13: 47-58.
162. Scheckowitz EM, Resnick MI. Imaging of the prostate. Benign prostatic hyperplasia. Urol Clin North Am 1995; 22: 321-332.
163. Schild SE, Buskirk SJ, Robinow JS. Prostate cancer: retrograde urethrography to improve treatment planning for radiation therapy. Radiology 1991; 181: 885-887.
164. Sciarra A, D'Eramo G, Casale P, Loreto A, Buscarini M, Di Nicola S, Seccareccia F, Di Silverio F. Relationship among symptom score, prostate volume, and urinary flow rates in 543 patients with and without benign prostatic hyperplasia. Prostate 1998; 34: 121-128.
165. Sirls LT, Kirkemo AK, Jay J. Lack of correlation of the American Urological Association Symptom 7 Index with urodynamic gladder outlet obstruction. Neurourol Urodyn 1996; 15: 447-456.
166. Smith WL, Lewis C, Bauman G, Rodrigues G, D'Souza D, Ash R, Ho D, Venkatesan V, Downey D, Fenster A. Prostate volume contouring: a 3D analysis of segmentation using 3DTRUS, CT, and MR. Int J Radiat Oncol Biol Phys 2007; 67: 1238-1247.
167. Solhjem MC, Davis BJ, Pisansky TM, Wilson TM, Mynderse LA, Herman MG, King BF, Geyer SM. Prostate volume measurement by transrectal ultrasound and computed tomography before and after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 2004; 60: 767-776.
168. Sonke GS, Kortmann BB, Verbeek AL, Kiemeney LA, Debruyne FM, de La Rossette JJ. Variability of pressure-flow studies in men with lower urinary tract symptoms. Neurourol Urodyn 2000; 19: 637-651.
169. Spangerg A, Terio H, Engberg A, Ask P. Quantification of urethral function based on Griffiths' model of flow through elastic tubes. Neurourl Urodyn 1989; 8: 29-52.
170. Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 1987; 317: 909-916.
171. Steele GS, Sleep DJ, Sullivan MP, et al. Combination of symptom score, flow rate and prostate volume to predict bladder outlet obstruction, in adult men with lower urinary tract symptoms. J Urol 1998; 158: 330.
172. Steele GS, Sullivan MP, Sleep DJ, Yalla SV. Combination of symptom score, flow rate and prostate volume for predicting bladder outflow obstruction in men with lower urinary tract symptoms. J Urol 2000; 164: 344-348.
173. Tan YH, Foo KT. Intravesical prostatic protrusion predicts the outcome of a trial without catheter following acute urine retention. J Urol 2003; 170: 2339.
174. Tchetgen MB, Oesterling JE. The role of prostate-specific antigen in the evaluation of benign prostatic hyperplasia. Urol Clin North Am 1995; 22: 333-344.
175. Terris MK, Afzal N, Kabalin JN. Correlation of transrectal ultrasound measurements of prostate and transition zone size with symptom score, bother score, urinary flow rate, and post-vold residual volume. Urology 1998; 52: 462-466.
176. Terris MK, Stamey TA. Determination of prostate volume by transrectal ultrasound. J Urol 1991; 145: 984-987.
177. Tewari A, Shinohara K, Narayan P. Transition zone volume and transition zone ratio: predictor of uroflow response to finasteride therapy in benign prostatic hyperplasia patients. Urology 1995; 45: 258-265.
178. Tong S, Cardinal HN, McLoughlin RF, Downey DB, Fenster A. Intra- and Inter-observer variability and reliability of prostate volume measurement via two-dimensional and three-dimensional ultrasound imaging. Ultrasound Med Biol 1998; 24: 673-681.
179. Tsukamoto T, Kumamoto Y, Masumori N, Miyakr H, Rhodes T, Girman GJ, Guess HA, Jacobsen SJ, Lieber MM. Prevalence of prostatism in Japanese men in a population based study with comparison to a similar American study. J Urol 1995; 154: 391-395.
180. van Venrooij GEPM, Boon TA. The value of symptom score, quality of life score, maximum urinary flow rate, residual volume and prostate size for the diagnosis of obstructive benign prostatic hyperplasia: a urodynamic analysis. J Urol 1996; 155: 2014-2018.
181. van Venrooij GEPM, Eckhardt MD, Boon TA. Noninvasive assessment of prostatic obstruction in elderly men with lower urinary tract symptoms associated with benign prostatic hyperplasia. Urology 2004; 63: 476-480.
182. Wachter S, Wachter-Gerstner N, Bock T, Goldner G, Kovacs G, Fransson A, Potter R. Interobserver comparison of CT and MRI-based prostate apex definition. Strahlenther Onkol 2002; 178: 263-268.
183. Walsh PC, Retie AB, Vaughan ED, et al. Campbell's Urology 7th Edition. 1995; W.B. Saunders.
184. Walter JS, Wheeler JS, Zaszczurynski P, Plishka M. Urodynamic measure of urethral cross-sectional area: application for obstructive uropathy. Neurouro Urodyn, 1994; 13: 571-586.
185. Watanabe H. New concept of BPH: PCAR Theory. Prostate 1998; 37: 116-125.
186. Watanabe H, Kato H, Kato T, Morita M, Tanaka M. Diagnostic application of ultrasonograhpy for the prostate. Nippon Hinyokika Gakkai Zasshi 1968; 59: 273-279.
187. Waterman FM, Yue N, Reisinger S, Dicker A, Corn BW. Effect of edema on the post-implant dosimetry of an I-125 prostate implant: A case study. Int J Radiat Oncol Biol Phys 1997; 38: 335-339.
188. Williams G. Other assessments: prostate size and prostate specific antigen. BJU Int 2000; 85(Suppl): 31-35.
189. Willins J, Wallner K. CT-based dosimetery for transperineal I-125 prostate brachytherapy. Int J Radiat Oncol Biol Phys 1997; 39: 347-353.
190. Wilson LD, Ennis R, Percarpio B, Peschel RE. Location of the prostatic apex and its relationship to the ischial tuberosities. Int J Radiat Oncol Biol Phys 1994; 29: 1133-1138.
191. Wiltshire KL, Brock KK, Haider MA, Zwahlen D, Kong V, Chan E, Moseley J, Bayley A, Catton C, Chung PWM, Gospodarowicz M, Milosevic M, Kneebone A, Warde P, Menard C. Anatomic boundaries of the clinical target volume (prostate bed) after radical prostatectomy. Prostate 2007; 69: 1090-1099.
192. Witjes WPJ, Aarnink RG, Ezz-El-Din K, Wijkstra H. The correlation between prostate volume, transition zone volume, transition zone index and clinical and urodynamic investigations in patients with lower urinary tract symptoms. Br J Urol 1997; 80: 84-90.
193. Xu C, Prince JL. Gradient vector flow: A new external force for snake. IEEE Proc, Conf On Comput Vis Patt Recog (CVPR) 1997: 66-71.
194. Yalla SV, Sullivan MP, Lecamwasam HS, DuBeau CE, Vickers MA, Cravalho EG. Correlation of American Urological Association symptom index with obstructive and nonobstructive prostatism. J Urol 1995; 153: 674.
195. Yamazaki Y, Yago R, Toma H. Sonographic characteristics of the urinary tract in healthy neonates. J Urol 2001; 166: 1054-1057.
196. Yang CH, Lin CA, Wang SJ, Lin TL. Computer tomography based noninvasive urodynamics diagnosis method as a predicting tool of bladder outlet obstruction. J Urol 2007; 177(suppl.): 574-574.
197. Yang CH, Wang SJ, Lin ATL, Lin CA. Factors affecting prostate volume estimation in computed tomography images. Med Dosim; DOI: 10.1016/j.meddos.2010.01.002.
198. Yuen JSP, Ngiap JTK, Cheng CWS, Foo KT. Effects of bladder volume on transabdominal ultrasound measurements of intravesical prostatic protrusion and volume. Int J Urol 2002; 9: 225-229.
199. Zhang KQ, Xu ZS, Zhang J, Wang HX, Zhang DQ, Shi BK. Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement. Urology 2007; 70: 1096-1099.
200. Zlotta AR, Djavan B, Damoun M, Roumeguere T, Petein M, Entezari K, Marberger M, Schulman CC. The importance of measuring the prostatic transition zone: an anatomical and radiological study. Br J Urol 1999; 84: 661-666.
201. Zou SQ, He XY. On pressure and velocity boundary conditions for the lattice Boltzmann BGK model. Phys Fluids 1997; 9: 1591-1598.