Shamusul Islam, Muhammad Nazir, Imtiaz Akhtar Bajwa, Junaid Habib Khan, Zahoor Ahmed, Ijaz Siddiquee, Mumtaz Ahmad, Sajjad Husain.
Role of trans rectal ultrasonography in diagnosing the prostate cancer.
J Fatima Jinnah Med Coll Lahore Jan ;1(3-4):80-3.

Objective: To assess the sensitivity of TRUS (Trans Rectal Ultra Sonography) in diagnosis CaP (Prostate cancer) by taking TRUS guided biopsies from the suspicious areas. Study design: Simple experimental study on the basis of convenience sampling .Place and duration of Study: The study was conducted in Department of Urology in collaboration with Department of Radiology and Department of Pathology at King Edward Medical College, Mayo Hospital Lahore from December 2002 to December 2004. Material and Methods: Thirty men with suspected CaP were enrolled in this study. All symptomatic patients with more than 50 years of age, with abnormal DRE (Digital Rectal Examination) indicating hard or nodular prostate and patients with elevated PSA (Prostatic Specific Antigen), more than 10ng/ml.; were included in the study. Patients with advanced metastatic carcinoma of the prostate with less life expectancy. Patients having any associated rectal pathology which interfere with doing TRUS guided biopsy were excluded from the study. All the patients were given ciprofloxacin 500mg BD and metronidazole 400mg TDS orally for three days prior to the biopsy..The transrectal ultrasound was carried out in both transverse & saggital planes and lesion directed biopsies were taken from the suspicious areas of each patient and submitted for histopthological analysis. Restults: Thirty patients were enrolled with age ranging from 51 to 80 years The mean PSA value of these patients was 23.6ng/ml . Ten patients had uniformly hard prostate on DRE while consistency of the prostate of 5 patients was firm to hard. On transrectal ultrasonography the average weight of the prostate was 37.4gm. Three to four lesion directed biopsies were taken from each patient. Total 110 biopsies were taken. Out of these 110 biopsies 70 (63.6% ) were from hypoechoic areas while 21(19.09%) were from hyperechoic areas and 19(17.23%) were from isoechoic areas.The histopathological reports of these lesion directed biopsies revealed that 75.7% hypoechoic, 47.6% hyperechoic and 63.1% isoechoic were positive for carcinoma of the prostate. Total 75 out of 110 biopsies were positive for CaP while 35 were negative. Therefore total 68.6% lesion directed biopsies were positive and 31.4% were negative for CaP. The sensitivity of TRUS in diagnosing CaP with lesion directed biopsies in this study turns out to be 68.6%. Conclusion: Transrectal ultrasonography has a definite role in the diagnosis of early CaP.

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