الفهرس 
Materials and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY
AND CONCLUSION
This work is a trial to evaluate transrectal ultrasound and measurement of prostate-specific antigen serum level as new diagnostic modalities in the early detection of prostate cancer, and evaluation of patients with benign prostatic hyperplasia.
We studied 42 men, older than 50 years in age presented with different obstructive and irritative lower urinary tract symptoms. They were evaluated by a full history and a full urological physical examination, all our patients found to have benign prostate without any suspicious of malignancy by digital rectal examination. Blood samples are taken from all of them before any manipulation of the prostate for measurement of prostate specifib antigen. All of them are then examined by transrectal ultrasound using a transrectal multiplanate 7. MHz mechanical sector transducer.
Transrectal ultrasound guided needle biopsies were taken from suspicious lesions of the prostate for histopathological determination of their nature.
Summary and Conclusion 104
Patients with elevated PSA level and normal sonography are exposed to random symptomatic biopsy to find cancers missed by transrectal US in these patients.
Our results showed that tansrectal ultrasound detect one case of non-palpable cancer by a rate of (1/42) (2.4%) and when combined with random systematic biopsy for patients with PSA level above 4.0 ng/ml. The detection rate increase to 2/42 (4.8%).
The results were compared with those of others published in the literature. The following conclusions could be reached :
-Transrectal US is an easy, safe non-invasive diagnostic modality for the prostate, adding important information to that available by palpation.
-Transrectal US multiplanar scanning can accurately guide needle biopsies of the prostate.
-The use of automatic biopsy devices yields adequate material with minimal complications.
-Transrectal US can detect some no palpable prostatic carcinoma (2.4%) for all patients with normal and elevated PSA, increased to 10% when transrectal US is used for patients with PSA above normal (4 ng/ml). Therefore, transrectal US
Summary and Conclusion 105
4.
should not be used routinely for old patients with normal DRE unless the PSA level above (4.0 ng/ml).
-Positive predictive’ value (PPV) of transrectal US for non-palpable hypoechoic lesions was (12.5%).
-Random systematic biopsy is recommended for patients with normal sonograms and PSA value above 10 ng/ml.
-The use of serum PSA as a stand alone in early detection would not be justified.
-Cancers detected by transrectal US and PSA measurement seems to be clinically significant.
-There is a statistically significant association between the serum PSA concentration and both patients age and prostatic glandular volume.
-Transrectal US enables volumetry of the prostatic adenoma. Safely and rapidly using the modified ellipsoid formula with an overall accuracy of 89.9%.