Abstract:

Introduction: Prostate cancer carries a high morbidity and mortality when not diagnosed. In resource limited countries many patients are likely to be diagnosed incidentally as they are operated for presumed benign prostatic hyperplasia. The information on the magnitude and risk factors of incidentally diagnosed prostatic carcinoma is lacking in our setting which could assist in planning on better strategies for early detection of the disease to reduce both morbidity and mortality from this disease.

Methods: A retrospective study involving all patients who underwent Trans-urethral resection prostatectomy for presumed benign prostatic enlargement was done at Bugando medical centre. Patients’ data including age, creatinine levels, UTS results, PSA and Biopsy were collected and analyses using STATA 11 and prevalence of incidental prostatic carcinoma and risk factors were assessed.

Results: A total of 152 underwent TURP in 2015 and all were included in this study. The median age of the participants was 69 [62-76.5] years. A total of 16 (10.53%) and 49 (32.24%) had hydronephrosis and elevated creatinine levels respectively. 86 (58.56%) patients had elevated PSA level >10 ng/ml with a median level of 93 (IQR 4-23) ng/dl. A total of 33 (21.71%) patients were found to have incidental carcinoma. The risk of incidental prostatic carcinoma was highest among those aged between 70 and 80 years (OR=3.3, p = 0.003) and those with PSA levels >10ng/ml (OR=3.7, p=0.005).

Conclusion: In conclusion this study has shown that prevalence of incidental prostatic carcinoma is significantly high among patients operated for presumed benign prostate enlargement. The risk of incidental carcinoma is highest at an age group of 70-80 years and those with elevated PSA levels above 10ng/ml. strategies to reduce this magnitude are required. Adoption of PSA in screening patients could before the age 70 years could potentially diagnose them early and manage them appropriately.