الفهرس 
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Abstract
Background: Benign prostatic hyperplasia (BPH) is the most common urological condition among elderly men, affecting approximately half of men over 80 years of age. It usually begins as a simple micro nodular hyperplasia with a subsequent macroscopic nodular enlargement that may result in bladder outlet obstruction (BOO) and the development of lower urinary tract symptoms (LUTS).
Aim of the Work: The aim of this prospective study is to determine if transition zone index (TZI) is a predictive value for success of trial without catheter in patients with BPH with acute urinary retention trying to evaluate the clinical usefulness of the index.
Patients and Methods: A total of 60 patients presented to the Urology Department at Ain Shams University hospitals and Kobri El Kobba Military hospital in Cairo with acute urinary retention secondary to BPH starting from Feb 2018 to August 2018. All Patients were left with the catheter for 1 week under umbrella of antibiotics and all of them received tamsulosin 0.4 mg single dose daily.
Results: As regarding age, the mean age of failure group was 64±7 years, but the mean age of successful group was 58.41±7.98 years (p-value=0.054) and these results were non significant. As regarding total prostate volume, transition zone volume and transition zone index, in our study, the mean of PV was 81.18±16.24 gm, the mean of TZV was 42.32±9.68 gm and the mean of TZI was 0.53±0.02 in successful TWOC. The mean PV was 144.44±32.06 gm, the mean TZV was 83.90±19.44 gm and TZI was 0.58±0.01 in failure group respectively (p-value=<0.001) and these results were statistically significant. As regarding PSA, the mean of PSA level in failure group and successful group were 5.53±1.65 ng/ml and 4.28±1.26 ng/ml (p-value=0.012) and these results were non significant. A cutoff value of 0.56 showed sensitivity and specificity of 100% for TZI.
Conclusion: TZI seems to be a reliable prognostic indicator with high sensitivity and specificity for successful TWOC in patients having acute urinary retention due to BPH which can avoid the hazards of failed TWOC.