Prostate Cancer Among Patients Presenting with Obstructive Lower Urinary Tract Symptoms at a Tertiary Hospital in South Western Uganda.

IF 2.7 Q2 UROLOGY & NEPHROLOGY

Research and Reports in Urology Pub Date : 2025-09-30 eCollection Date: 2025-01-01 DOI:10.2147/RRU.S515662

Willy Kyegombe, Okidi Ronald, Anitah Nimusima, Yakobo Nsubuga, Brenda Nakitto, Christine Nannungi, Joseph Epodoi, Ronald Opito, Eddymond Ekuk, Marvin Mutakooha Mwesigwa

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Abstract

Background: Prostate cancer is currently the second commonest male cancer both globally and in Uganda. Men are often tested after presenting with obstructive lower urinary tract symptoms (LUTS). We evaluated total prostate-specific antigen patterns (tPSA), digital rectal examination (DRE) findings, histological findings and prostate cancer rates among patients presenting to Mbarara regional referral hospital with obstructive LUTS.

Methods: This was a cross-sectional study of 140 patients aged ≥50 with obstructive LUTS. Data on demographics and severity of LUTS was collected, plus the results of tPSA testing and DRE. Later, digitally guided transrectal tru-cut prostate biopsy was performed, if necessary. Analysis was done using SPSS (Statistical Package for Social Scientists), version 14. Confidence interval (CI) was set at 95% and P at 0.005.

Results: The majority of patients had severe LUTS (n=103, 73.57%), with a median tPSA of 14.4 ng/mL. Ninety-nine patients experienced digitally guided transrectal tru-cut prostate biopsy (70.71%; Fisher's exact test = 0.001). DRE abnormalities were found in 57.14% (n=80) of participants and these carried a higher risk for prostate cancer diagnosis (risk ratio = 5.895; Fisher's exact test = 0.04; CI 95%: 1.59-21.822). The tru-cut biopsy positivity rate was high, at 46% (45/99; 95% CI: 30.1-46.3); all had prostate adenocarcinoma and the majority (77.78%, n=35) had a total Gleason score of 8 and above. Of those who had a malignancy, more than a quarter were between 60-80 years of age (37.8%, n = 17). There was no statistically significant relationship between LUTs and prostate cancer diagnosis (Fisher's exact test 2-sided = 0.84).

Conclusion: Although severity of LUTS was not predictive of cancer, there was a high rate of advanced prostate cancer among study participants. DRE remains a valuable tool for identifying potential prostate cancer cases, especially in settings where PSA testing may be limited. Further research is needed to explore effective screening strategies and improve outcomes for men with prostate cancer in Uganda.

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在乌干达西南部一家三级医院出现下尿路梗阻性症状的患者中发现前列腺癌。

背景：前列腺癌目前是全球和乌干达第二常见的男性癌症。男性通常在出现下尿路梗阻性症状（LUTS）后进行检测。我们评估了在Mbarara地区转诊医院就诊的梗阻性LUTS患者的总前列腺特异性抗原模式（tPSA）、直肠指检（DRE）结果、组织学结果和前列腺癌发病率。方法：对140例年龄≥50岁的阻塞性LUTS患者进行横断面研究。收集LUTS的人口统计学和严重程度数据，以及tPSA检测和DRE结果。随后，如有必要，进行数字引导经直肠真切前列腺活检。分析使用SPSS（社会科学家统计软件包），版本14。置信区间（CI）为95%，P为0.005。结果：大多数患者有严重LUTS (n=103, 73.57%)，中位tPSA为14.4 ng/mL。99例患者行数字引导下经直肠真切前列腺活检（70.71%；Fisher精确检验= 0.001）。在57.14% （n=80）的参与者中发现了DRE异常，这些参与者具有更高的前列腺癌诊断风险（风险比= 5.895；Fisher精确检验= 0.04;CI 95%: 1.59-21.822）。真切活检阳性率高，为46% (45/99;95% CI: 30.1-46.3)；所有患者均为前列腺腺癌，绝大多数（77.78%,n=35） Gleason总分在8分及以上。在恶性肿瘤患者中，超过四分之一的患者年龄在60-80岁之间（37.8%,n = 17）。LUTs与前列腺癌诊断无统计学意义（Fisher精确检验双侧= 0.84）。结论：尽管LUTS的严重程度不能预测癌症，但研究参与者中晚期前列腺癌的发生率很高。DRE仍然是识别潜在前列腺癌病例的有价值的工具，特别是在PSA检测可能有限的情况下。需要进一步的研究来探索有效的筛查策略并改善乌干达男性前列腺癌患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Research and Reports in Urology UROLOGY & NEPHROLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Research and Reports in Urology is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric urology in the clinic and laboratory including the following topics: Pathology, pathophysiology of urological disease Investigation and treatment of urological disease Pharmacology of drugs used for the treatment of urological disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered.