Primary neoplasms arising in vesical diverticula are rare and present special problems in diagnosis and treatment. We report a case of primary carcinoma arising in vesical diverticula with associated benign prostatic hypertrophy.
Diagnosis ; Diverticulum* ; Prostatic Hyperplasia ; Urinary Bladder Neoplasms

These patients were admitted to hospital due to diuretic difficulty, increasing frequency of micturition (89.63%) and retention of urine (10.37%). Histopathological examination: Most of lesion are benign prostatic hyperplasia (98%, 15%). Carcinoma was detected only in 10 cases (1.85%).
Prostate ; Prostatic Hyperplasia ; diagnosis ; anatomy & histology ; surgery

From July 1998 to July 2001, 128 patients age ranged from 54-90 (67.2) with benign prostatic hypertrophy (BHP) were treated by transurethral resection of the prostate (TURP) in Urinary Department - Military Hospital 108. The indication for TURP was symptomatic prostatism (100%), urinary tract infection (10.9%), acute retention (4.6%) and renal insufficiency (2.3%). TURP is the technique of choice for small (<20g) - 14.1% and medium-size prostate (20-60g) - 85.9%. Retention, hemorrhage and urinary tract infection are the most frequent complications at and after operation. Mastering of technique and careful assessment of patient and of local status are two important factors contributing to reduction of the rate of the resectoscopy complications. The outcomes were: good and average: 91.5%, bad: 8.5%, no one die
Transurethral Resection of Prostate ; Prostatic Hyperplasia ; Hemorrhage ; Hypertrophy ; diagnosis

Humans ; Male ; Practice Guidelines as Topic ; Prostatic Hyperplasia ; diagnosis ; therapy

PURPOSE: Most studies have shown considerable overlap between benign prostatic hyperplasia(BPH) and cancer, using a prostate specific antigen(PSA) cut-off point of 4.0ng/ml. Because of lack of sensitivity and specificity, the value of PSA measurement in the diagnosis of prostate cancer has been questioned. The concept of PSA density(PSAD) was introduced to enhance the specificity of serum PSA. To determine the value of PSAD in the diagnosis of prostate cancer, we investigated whether PSAD-based clinical guidelines could help in the diagnosis of prostate cancer and assist in avoiding a significant number of biopsies. MATERIALS AND METHODS: Retrospective data were analysed from a selected population of 130 patients(mean age 66 years, range 42-86), 54 with histopathologically diagnosed prostate cancer and 76 with BPH. DRE(digital rectal examination) and TRUS(transrectal ultrasonography) were performed and PSA and PSAD were determined for each patient. RESULTS: The median PSA level was 7.0ng/ml(range 0.6-87ng/m1) in the patients with a benign diagnosis and 25.5ng/ml(range 2.2-736ng/m1) in those with malignancies. Also, the median PSAD was 0.18ng/m1/cm3(range 0.02-2.56ng/ml/cm3) in the benign group and 0.75ng/m1/cm3(range 0.06-22.3ng/m1/cm3) in the malignant group. Both PSA and PSAD discriminated BPH from cancer in a whole range of PSA level and were statistically significant. Of the 130 patients, 49(377 %) had a PSA level in the intermediate range(4.0-10.0ng/ml). In these patients, the median PSA was 6.5ng/ml(range 4.2-10ng/m1) In the benign group and 5.2ng/ml(range 4.1-9.8ng/ml) in the malignant group. Also, the median PSAD was 0.16ng/m1/cm3(range 0.07-0.39ng/m1/cm3) in the benign group and 0.17ng/m1/cm3 (range 0.08-0.27ng/m1/cm3) in the malignant group Both PSA and PSAD had no discriminating ability between BPH arid cancer in the Intermediate PSA range(4.0-10.0ng/ml). CONCLUSIONS: PSAD was of no additional value over serum PSA measurement in discriminating BPH from cancer for the population with intermediate PSA levels.
Adenocarcinoma* ; Biopsy ; Diagnosis* ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Retrospective Studies ; Sensitivity and Specificity

We analyzed the results of the prostate biopsies of 64 patients with elevated serum PSA (>4ng/ ml) at Kangbuk Samsung Hospital from March 1993 to February 1996. Of 64 patients, 11 patients (17%) had prostate cancer and 53 patients (83%) were diagnosed as benign prostatic hyperplasia. Among the patients with prostate cancer, 1 patient had serum PSA between 4.1 to 10.0ng/ml, 2 patients between 10.1 to 20.0ng/ml and 8 patients above 20ng/ml The detection rates of prostate cancer in each serum PSA levels were 3%, 15% and 36% respectively. Two of 17 patients with both negative DRE and TRUS were diagnosed as prostate cancer Two of 21 patients with positive TRUS and negative DRE had prostate cancer but none of 8 patients with positive DRE and negative TRUS had prostate cancer. Seven of 18 patients with both positive TRUS and DRE had prostate cancer. The sensitivity, specificity, positive predictive value and overall accuracy of DRE and TRUS in patients with elevated PSA (>4ng/m1) were 64%, 64%, 27%, 64% and 82%, 43%, 23%, 50% respectively in patients with elevated serum PSA (>4ng/ml). In conclusion, these results suggest that prostate biopsy in early diagnosis of prostate cancer would be needed for the patients with elevated serum PSA (>4ng/ml) regardless of the results of DRE and TRUS.
Biopsy* ; Early Diagnosis ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Sensitivity and Specificity

PURPOSE: Insulin-like growth factor binding protein 3 (IGFBP-3) binds to IGF and acid labile subunit in blood, that regulates the action of IGF by modulating the interaction of IGF with the IGF receptor. Recent studies have shown that IGFBP-3 levels are decreased in prostate cancer patients. We examined IGFBP-3 profiles in prostate cancer patients and determined the effect of treatment on serum IGFBP-3 level in those patients. MATERIALS AND METHODS: Control groups were composed of age-matched healthy subjects and patients with benign prostatic hyperplasia (BPH). Patients with prostate cancer were divided into localized, locally advanced, metastatic and hormone-refractory. Serum samples were collected and stored at 70oC until use. The IGFBP-3 profile was measured by Western ligand blots. RESULTS: The serum IGFBP-3 level in patients with prostate cancer was significantly lower than healthy subjects or patients with BPH. Following the treatment of prostate cancer, IGFBP-3 was increased compared to that seen in pretreated prostate cancer. In hormone-refractory prostate cancer, IGFBP-3 was decreased again. However, there was no correlation between IGFBP-3 and tumor stage or Gleason score. CONCLUSIONS: These data show that IGFBP-3 levels are decreased in pretreated and hormone-refractory prostate cancer. Our results demonstrate that serum IGFBP-3 may be a useful marker in the detection and management of prostate cancer.
Diagnosis* ; Humans ; Insulin-Like Growth Factor Binding Protein 3* ; Neoplasm Grading ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms*

PURPOSE: We designed the study to compare the efficacy of digital rectal examination(DRE), serum prostate specific antigen(PSA) & transrectal ultrasonography (TRUS) for the early detection of prostate cancer. MATERIALS AND METHODS: We analyzed the result of the prostate biopsies of 162 patients with abnormal hard nodule or asymmetricity on DRE, elevated serum PSA(> 4ng/ml) or hypoechoic lesion in peripheral zone on TRUS from August 1994 to June 1997. RESULTS: Of 162 patients, 26 patients(16%) had prostate cancer and 136 patients(84%) were diagnosed as benign prostatic hyperplasia. DRE, serum PSA and TRUS had sensitivities of 77%, 100% and 92%, respectively and positive predictive values(PPVs) of 48%, 26% and 19%, respectively. The sensitivities of high serum PSA(> 4ng/ml) with positive DRE, positive DRE with positive TRUS and high serum PSA with positive TRUS were 77%, 73% and 92%, respectively and the PPVs were 65%, 51% and 34%, respectively. In cases both DRE and TRUS were positive with high serum PSA, sensitivity and PPV were 73% and 68%, respectively CONCLUSIONS: The combination of DRE and serum PSA would be recommended as a first line examination in the diagnosis of prostate cancer regarding the sensitivity and PPV.
Biopsy ; Diagnosis ; Digital Rectal Examination* ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Ultrasonography*

PURPOSE: The purpose of this study was to determine whether histologic inflammation (HI) in initial and repeat prostate biopsy specimens was significantly associated with the detection of prostate cancer. MATERIALS AND METHODS: Between 2005 and 2017, the clinicopathological records of patients with high prostate-specific antigen (PSA) levels who underwent initial and repeat prostate biopsies were retrospectively reviewed. The presence of HI and its degree in each biopsied specimen were interpreted by one uropathologist with 20 years of experience. The association between HI and cancer diagnosis was statistically assessed, with p < 0.05 considered significant, and the cancer and non-cancer groups were compared. RESULTS: Among the 522 patients with a median PSA levels of 6.5 ng/dL, including 258 (49.4%) whose cancer was diagnosed following repeat biopsy, the median degrees of HI in the initial and repeat biopsies were 25.0% and 41.7%, respectively. Furthermore, 211 (40.4%) and 247 (47.3%) patients had HI (> 0%) on biopsied specimens, respectively. Comparison of the cancer and noncancer groups revealed that a greater rate of HI specimens in the initial biopsy was associated with fewer prostate cancer diagnoses following repeat biopsy (p < 0.001). Other comparisons between the cancer and non-cancer groups showed that the cancer group had a significantly higher rate of hypertension, whereas those non-cancer group had a significantly higher rate of benign prostatic hyperplasia and prostatitis (p < 0.05). CONCLUSION: A finding of a lesser degree of HI in the initial and a greater degree of HI in the repeat biopsied specimens was associated with the higher probability of cancer diagnosis in patients with high PSA levels.
Biopsy ; Diagnosis ; Humans ; Hypertension ; Inflammation ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; Retrospective Studies

We investigated a correlation of serum prostate specific antigen(PSA) and preoperative prostatic volume measured by transrectal ultrasonography (TRUS) in 66 patients with pathologically con- firmed benign prostatic hyperplasia (BPH), as aids in the early detection of prostate cancer and in the improvement of specificity in BPH. The preoperative serum PSA value was also measured in 18 patients with pathologically confirmed prostate cancer and 15 men without prostatic disease as normal control using Tandem-R PSA radioimmunometric assay. There was a highly significant correlation between natural logarithm transformed PSA(In PSA) and non-transformed prostatic volume by linear regression analysis(r=0.6668, p<0.0001). Given above data, we determined a volume adjusted 95th percentile upper confidence limit for n PSA as an appropriate cutoff between normal and abnormal PSA value, according to prostatic volume in BPH. In the patients with BPH and prostate cancer, sensitivity, specificity, diagnostic accuracy and positive predictive value were 94%, 72%, 68% and 48%, respectively. A statistical results by the volume-adjusted cutoff for in PSA was similar to that at 10 ng/ml as cutoff for PSA value. Above 40ml in prostatic volume, however, a false positive rate was decreased in inverse proportion to prostatic volume in BPH. In summary, the prostatic volume must be considered in BPH patients with elevated serum PSA value, negative digital rectal examination and negative TRUS of prostate. And when the volume adjusted PSA cutoff is clinically applied to BPH patients for the early detection of prostate cancer, we thought that the false positive rate can be decreased in BPH patients.
Diagnosis* ; Digital Rectal Examination ; Humans ; Linear Models ; Male ; Prostate* ; Prostatic Diseases ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Sensitivity and Specificity ; Ultrasonography*