Prostatic Hypertrophy: Correlation between Digital Rectal Examination, Ultrasound, PSA Assay, and Histopathological Findings in Bangui

Prostatic diseases represent the most frequent causes of morbidity and mortality in urological consultations among men, most often from the age of 50, and constitute a public health problem. The aim of this study was to contribute to improving the etiological diagnosis of prostatic hypertrophy. Patients and Methods: This was a cross-sectional study conducted from January 1 to December 31, 2020, at the Sino-Central African Friendship University Hospital (CHU) in Bangui, involving patients presenting with lower urinary tract symptoms in whom homogeneous or heterogeneous prostatic hypertrophy was identified on ultrasonography. Additional inclusion criteria included documentation of digital rectal examination, PSA measurement, and histological analysis of the surgical specimen. Results: A total of 51 patients were included in this study. Clinical symptoms were dominated by pollakuiria in 72.6% of cases. Ultrasonography was less sensitive and less specific (with a sensitivity of 44.4% and a specificity of 57.7%) for the diagnosis of benign prostatic hypertrophy or prostate cancer. The homogeneous or heterogeneous ultrasonographic appearance of the prostate, as well as PSA levels greater than 100 ng/mL, were not specific for prostate cancer. Digital rectal examination demonstrated high sensitivity (92.9%) and high specificity (88.9%). Conclusion: Prostatic hypertrophy is a very common condition in urological consultations and constitutes a public health problem. Clinical manifestations were dominated by pollakuiria. Digital rectal examination remains the key clinical assessment. Elevated PSA levels and ultrasonography alone cannot reliably differentiate between benign and malignant prostatic hypertrophy; considered the gold standard, histopathological examination remains the reference diagnostic test.