Prostate specific antigen versus digital rectal examination as screening for CA prostate in Sudanese patients

Objectives: The aim of this study is to compare the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer among Sudanese patients presenting with lower urinary tract symptoms (LUTS). Material and Methods: A prospective study was carried out in Gezira Hospital for Renal Diseases and Surgery in the period of June 2003- May 2005. Patients presenting with LUTS, had been screened for prostate cancer using PSA and DRE examination.. Serum PSA and DRE were measured in all patients. Trans rectal biopsy was performed if the PSA was over 4ng and /or abnormal DRE. Results: A total of 194 elderly male pa3ents presen3ng with lower urinary tract symptoms (LUTS), 140 of them were at last diagnosed as benign prostate hyperplasia (BPH) and 54 pa3ents were been confirmed with prostate cancer (PCa). Their mean age was 65 years (range 45-90). Elevated level of PSA (> 4 ng/ml) was found in all the patients with prostate cancer (n= 54) and 68.6% (n= 96) of BPH patients. The rate of prostate cancer detection showed to be 25.7% for PSA > 4ng/ml, 13.31% for abnormal (positive) finding of DRE, and 27.8% for combination of the positive DRE and PSA > 4 ng/ml. The rate of BPH detec3on showed to be 68.6% for PSA > 4ng/ml, 28.6% for posi3ve finding of DRE, and 4.1% for combination of the positive DRE and PSA > 4 ng/ml. Conclusion: It was found that PSA determination detects a considerable proportion of tumors missed by DRE. And the combination of PSA and DRE escalates the probability of prostate cancer detection,

Urological Injuries during Pelvic Surgery in Women; Gezira; Central Sudan

Injuries to the ureter and bladder are common in female pelvic surgery; sometimes extremely common to be considered as traditional. This is a retrospective study conducted in Gezira Hospital for Renal Disease and Surgery; Medani Teaching Hospital and Medani Maternity Hospital; #ad Medani; Sudan. #e included $paetents 'ith urological injuries follo'ing obstetrical gynecology interveneton in the previous ( years. The interaoperaetve injuries consettuted; -.; 'hile the remote injuries 'ere 6+7(.6 -.. #e conclude that the urological injuries are common complications during pelvic surgery; associated mainly 'ith abdominal hysterectomies and Cesarean section