Value of fine needle aspiration cytology under ultra-sound guided biopsy in the diagnosis of prostatic cancer

The detection of carcinoma of prostate [CaP] by trans rectal ultrasound [TRUS] depends on the feature produced by the new growth, which leads to changes in the glandular-stromal architecture, appears as Changes in the echogenicity of the prostatic lesion. The fine needle can be guided to the area of suspicion and cytology is done. This prospective study was conducted to demonstrate the usefulness of the fine needle aspiration cytology [FNAC] under transrectal ultrasound [TRUS] guidance in detection of carcinoma of the prostate [CaP]. Fifty male patients aged between [46 - 86] years, were chosen selectively, all with voiding symptoms and suspicion of CaP from an elevated prostate specific antigen [PSA] above the level of 4 ng/ml in all patients. Thirty patients had abnormal finding on digital rectal examination [DRE], thirty three patients had TRUS abnormal findings. This procedure was carried out in out - patient basis. The cytological results were compared with the tissue diagnoses obtained by surgical interventions. The cytological results revealed 24 case of malignancy and benign in the rest 26 case [23 case of BPH and 3cases of prostatitis]. Malignancy was correctly diagnosed by using cytology in 24 out of 28 case confirmed by histopathology as CaP. One case was considered initially as false positive, the cytological result consistent with adenocarcinoma but the histopathology failed to prove it. The statistical analysis revealed that the sensitivity, specificity and accuracy were 85%. 100% and 92% respectively. We conclude that FNAC under TRUS guide can be considered as an initial safe cost effective and reliable method for diagnosing of Prostate cancer

Correlations between preoperative measurement of prostate volume by transabdominal and transrectal ultrasound with open prostatectomy

Despite being formally included in the assessment of patients presenting with lower urinary tract symptoms [LUTS], transrectal ultrasonography [TRUS] is not routinely offered to these patients. Data exist on the superiority of TRUS over transabdominal ultrasound in accurately predicting prostate volume. To evaluate which of these methods are more accurate in calculation of prostate volume. The volume is most commonly measured using the formula, prostate volume=height×width×length/6, which is derived considering the gland as ellipsoid, Thirty five patients aged [60-75] years; with mean age [65.1 +/- 4.016] years and mean of serum prostate specific antigen [PSA] [1.429 +/- 0.3149] complaining from LUTS due to benign prostatic hyperplasia [BPH] underwent suprapubic prostatectomy .TRUS was performed in all patients preoperatively and calculations of the prostate volume were made. These were compared with respective transabdominal calculations of the prostate volume as well as the enucleated specimen weight. TRUS slightly underestimated weight by [8.6%].while transabdominal U/S overestimated it by [94.3%] Pearson correlation analysis indicated TRUS as a better predictor of weight [0.661] at P-value of <0.001 [extremely significant] followed by transabdominal U/S [0.465] at P-Value of <0.01 [highly significant]. TRUS is more accurate than transabdominal U/S in predicting adenoma volume in patients with BPH

Transurethral microwave thermotherapy [TUMT] for benign prostatic hyperplasia

Benign prostatic hyperplasia [BPH] is one of the most common diseases of the aging male. Minimally invasive therapies for treatment of BPH compete with the gold standard transurethral resection of the prostate [TURP]. The aim of this study is to assess the efficacy of transurethral microwave therapy [TUMT] in patients with otherwise poor general health. Thirty [30] patients with associated chronic medical diseases and lower urinary tract symptoms due to BPH were subjected for TUMT as an outpatient single session procedure, from June 2001 to August 2005. Follow up was performed 2 weeks, and then one month following treatment clinically and by assessing residual urine volume, maximal flow rate and prostate size. Out of [28] treated patients, [21] were labeled as non - responders as they were unable to pass urine freely 2-weeks after a trial of decatheterisation. In contrast [7] patients passed urine freely after decatheterisation. In the latter group, it was found that there was no statistical significance of the values of maximum flow rate, residual urine volume or prostate size between pre- and one month post TUMT. TUMT is a possible option for the treatment of BPH in poor general health patients or those refusing other surgical modalities. However, it did not prove to be effective for those patients with chronic urinary retention and BPH