Ahmet Halil SEVİNÇ, Burcu HANCI, Fatih TARHAN
Southern Clinics of Istanbul Eurasia - 2026;37(3):306-312
Objective: To develop a novel, standardized, and objective method for estimating prostate volume using digital rectal examination (DRE) and to establish a treatment-oriented grading system. Methods: A total of 330 men aged >=45 years scheduled for prostate needle biopsy were prospectively analyzed (Group 1). During DRE, the width, length, and height of the posterior prostate surface were measured using the examiner's pre-measured index finger. Reproducibility was assessed in 63 patients examined independently by two urologists (Group 2). Posterior surface area and volume were calculated using ellipse and ellipsoid formulas. Prostate volume measured by transrectal ultrasonography (TRUS) served as the reference standard. Linear regression analyses were performed to generate prediction equations. Results: Posterior surface area predicted TRUS-measured prostate volume more strongly than palpable posterior prostate volume, explaining 91% of the variance (R²=0.909, p<0.0001). No significant interobserver difference was observed (p=0.061), while strong correlation (r=0.733, p<0.0001) and high reliability were demonstrated (ICC=0.821). Conclusions: Posterior prostate surface area measured by DRE is a reliable and reproducible approach for estimating prostate volume categories. Further validation of this method using advanced imaging techniques such as magnetic resonance imaging is recommended.
