Evaluation of prostate - related complaints by transrectal ultrasonography, digital rectal examination and prostatic specific antigen

ABSTRACT

120 male patients with mean age of 55.1 +/- 8.1 years [40 - 78 years] presented with symptoms of prostatism. Symptoms were quantified using the American Urological Association [A.U.A] symptom score. They were subjected to digital rectal examination [D. R. E], prostates specific antigen estimation [P. S. A] transrectal ultrasound [TRUS] and biopsy was obtained from suspicious lesions by the biopsy gun and examined for histopathology. The results were analysed statistically. The results showed three groups of echopattern, isoechoic [46.2%] hyperechoic [6.7%] and hypoechoic [29.1]. DRE suspected 6 lesions to be malignant. All proved to be hypoechoic by TRUS and confirmed malignant histologically. Of all the hypoechoic lesions biopsy, 8 patients including the six patients suspected by DRE had prostatic carcinoma. Sensitivity of DRE in detection of prostatic carcinoma was 75%, PSA [100%] and TRUS [100%] Specificity reached 93.3% in DRE but decreased to 87.5% using PSA and 70.8% by TRUs