Background: The diagnosis of prostate cancer (PCa) relies on clinical assessment with digital rectal examination, serum PSA and histological examination. Limitations in our technical facilities, high financial cost of ultrasound-guided biopsy often prevent us from implementing the guidelines on the practice of prostate biopsy. Methods: We conducted a retrospective and cross-sectional descriptive study comparing digital-guided and ultrasound-guided transrectal prostate biopsy of 400 patients over a period of 12 years in the Yaounde Central Hospital. We reviewed files of patients who underwent digital and ultrasound guided biopsy procedures. Data was analyzed using EPI info 7.0. Parametric variables were reported as means and standard deviations and percentages and counts were used to report categorical variables. Results: Out of the 400 patients, 292 digital-guided transrectal biopsies (73%) and 108 ultrasound-guided transrectal biopsies (27%) were performed in patients who were suspected of having prostate cancer (PCa). Patients were aged between 39 to 90 years. Both procedures were effective in identifying prostate cancer. Gleason score between 2 to 10 detected prostate adenocarcinoma for 301 patients (75.2%). The complications included anal pain, rectal bleeding, hematuria and urinary tract infections, with an occurrence rate similar for both ultrasound-guided (2.25%) and digitally-guided techniques (2.5%). Seven patients (1.75%) required hospitalization for management of complications. The mortality rate was null. Conclusion: Both techniques are effective in detecting PCa with the similar complication rates. Digital-guided trans-rectal prostate biopsy still has its place in a resource-limited setting like ours.
References
[1]
Rozet, F., et al. (2018) Recommandations françaises du Comité de Cancérologie de l’AFU pour le cancer de la prostate—Actualisation 2018-2020: Cancer de la prostate. Progrès en Urologie, 28, R81-R132. https://doi.org/10.1016/j.purol.2019.01.007
[2]
Aubert, J. (1992) Complications des biopsies prostatiques. Analyse d’une série de 4764 biopsies. Progrès en Urologie, 2, 484-487.
[3]
Mondet, F., Boyer, C., Oddou, J.H., Corsois, L. and Collomb, D. (2009) La mention systématique d’un indice de qualité dans les comptes rendus de biopsies prostatiques influence les pratiques professionnelles. Progrès en Urologie, 19, 825-829. https://doi.org/10.1016/j.purol.2019.01.007
[4]
Bruyère, F., Cros, L., Destembert, B., Turban, N., Dumon, R., Freslon, L., Malavialle, F., Houin, P., Badiere, H., Charlon, R. and Lanson, Y. (2005) Yechnique de realisation des Biopsie Prostatiques dans la region du centre. Progrès en Urologie, 15, 427-432.
[5]
Cupp, M.R. and Oesterling, J.E. (1993) Prostate-Specific Antigen, Digital Rectal Examination, and Transrectal Ultrasonography: Their Roles in Diagnosing Early Prostate Cancer. Mayo Clinic Proceedings, 68, 297-306. https://doi.org/10.1016/s0025-6196(12)60052-4
[6]
Chodak, G.W., Wald, V., Parmer, E., Watanabe, H., Ohe, H. and Saitoh, M. (1986) Comparison of Digital Examination and Transrectal Ultrasonography for the Diagnosis of Prostatic Cancer. Journal of Urology, 135, 951-954. https://doi.org/10.1016/S0022-5347(17)45935-0
[7]
Pokorny, M.R., de Rooij, M., Duncan, E., Schroder, F.H., Barentsz, P.R., et al. (2014) Prospective Study of Diagnostic Accuracy Comparing Prostate Cancer Detection by Transrectal Ultrasound-Guided Biopsy versus Magnetic Resonance (MR) Imaging with Subsequent MR-Guided Biopsy in Men without Previous Prostate Biopsies. European Urology, 66, 22-29.
[8]
Holm, H.H. and Gammelgaard, J. (1981) Ultrasonically Guided Precise Needle Placement in the Prostate and the Seminal Vesicles. Journal of Urology, 125, 385-387. https://doi.org/10.1016/S0022-5347(17)55044-2
[9]
Renfer, L.G., Schow, D., Thompson, I.M. and Optenberg, S. (1995) Is Ultrasound Guidance Necessary for Transrectal Prostate Biopsy? Journal of Urology, 154, 1390-1391. https://doi.org/10.1016/S0022-5347(01)66873-3
[10]
Sow, M., Essame Oyono, J.L., Nkegoum, B. and Mbakop, A. (2001) La biopsie de la prostate: Indications, technique et resultants. à propos de 161 cas colligés au Service d’Urologie de l’Hôpital central de Yaoundé. Médecine d’Afrique Noire, 48, 159-162.
[11]
Mbassi, A.A., Magni, E.T., Douanla, D.E., Kamga, J., Mekeme, J., Jiatsa, N.L.R., Ngo Nonga, B., Sando, Z., Angwafo, F., et al. (2017) A Comparative Study of Digit-Guided Versus-Echo-Guided Prostate Biopsies in Diagnosing Prostate Cancer at Yaounde Central Hospital and at le Centre Medical la Cathedrale-Cameroon. Journal of Cancer Research and Clinical Oncology, 1, 2-6. https://www.springer.com/
[12]
Resnick, M.I. (1988) Transrectal Ultrasound Guided versus Digitally Directed Prostatic Biopsy: A Comparative Study. Journal of Urology, 139, 754-757. https://doi.org/10.1016/S0022-5347(17)42623-1
[13]
Van Every, M.J. and Rooney, B. (1993) Comparison of Ultrasound-Guided and Digitally Directed Transrectal Biopsy of Palpable Prostate Lesions. Urology, 42, 677-679. https://doi.org/10.1016/0090-4295(93)90532-F
[14]
Weaver, R.P., Noble, M.J. and Weigel, J.W. (1991) Correlation of Ultrasound- Guided and Digitally Directed Transrectal Biopsies of Palpable Prostatic Abnormalities. Journal of Urology, 145, 516-518. https://doi.org/10.1016/S0022-5347(17)38384-2
[15]
Türkeri, L., Tarcan, T., Biren, T., Küllü, S. and Akdaş, A. (1995) Transrectal Ultrasonography versus Digitally Guided Prostate Biopsies in Patients with Palpable Lesions on Digital Rectal Examination. British Journal of Urology, 76, 184-186. https://doi.org/10.1111/j.1464-410X.1995.tb07671.x
[16]
Diarra, A., Keita, M.M., Eyongeta, D.E., Coulibaly, M., Berthe, H. and Ouattara, Z. (2018) La Biopsie De La Prostate Au Service D’urologie Du Chu Luxembourg: A Propos De 100 Cas. Uro’Andro, 1, 519-523.
[17]
Ndiaye, M., Jalloh, M., Ndoye, M., et al. (2021) Ultrasound-Guided Prostate Biopsy: Indication, Morbidity and Outcome at Hopital General Idrissa Pouye. African Journal of Urology, 27, Article No. 54. https://doi.org/10.1186/s12301-021-00155-9
[18]
Presti Jr, J.C., O’Dowd, G.J., Miller, M.C., Mattu, R. and Veltri, R.W. (2013) Extended Peripheral Zone Biopsy Schemes Increase Cancer Detection Rates and Minimize Variance in Prostate Specific Antigen and Age Related Cancer Rates: Results of a Community Multi-Practice Study. Journal of Urology, 169, 125-129. https://doi.org/10.1016/S0022-5347(05)64051-7
[19]
Lechevalier, E. (1996) La ponction biopsie de prostate. Progrès en Urologie, 6, 507-518.
