Harrison NW, Eshleman JL, Ngugi PM.Ethical issues in the developing world..
Br J Urol. 1995 Nov;76 Suppl 2:93-6. Review.. : Heinrich Boll Foundation. Abstract
OBJECTIVES: To determine the histology of the prostate in prostatectomy done for benign prostatic hypertrology (BPH), and prostate needle biopsy done for raised prostatic specific antigen (PSA). DESIGN: A retrospective study. SETTINGS: Nairobi Hospital, Kenyatta National Hospital and Upper Hill Medical Centre. SUBJECTS: The records of all the patients who had prostatectomy for BPH or trans-rectal needle biopsy of the prostate for raised prostatic specific antigen by the author and whose histology was determined at the Nairobi Hospital between May 2004 and December 2006. RESULTS: A total of 108 specimens from 108 patients were sent to the laboratory. The ages of the patients ranged from 48 years to 83 years with a mean of 71.3 years. Of the 108 specimens submitted 82 were benign prostatic hypertrophy and 26 were carcinoma of the prostate. Out of 78 prostatectomy specimens ten (12.8%) had prostate cancer. In the needle biopsy group 16 out of 30 (53%) had prostate cancer. In total there were 82 (76%) patients with histology of benign prostate enlargement and 26 (24%) with histology of prostate cancer. CONCLUSION: Prostate cancer is a common disease in Kenya and a lot of it is important cancer as it will progress and cause death. In this poor resource setting it is possible to make diagnosis of prostate cancer even in the absence of transrectal ultrasound (TRUS) to help biopsy the prostate. The higher the prostatic specific antigen in asymptomatic patients the higher the yield of prostate cancer on biopsy of the prostate.