Detection of incidental prostate cancer with transurethral resection of the prostate in patients with symptoms of the lower urinary tract and elevated specific prostate antigen of the General Hospital of Mexico

Abstract

Objective: To evaluate the rate of early detection of transition zone prostate cancer through transurethral resection of the prostate (turp) in patients suspected of having cancer, with or without a negative transrectal biopsy of the prostate (trbp).

Materials and methods: A retrospective and cross-sectional study evaluated the efficacy of turp in the early detection of transition zone prostate cancer. The analysis included male patients over 40 years of age that sought medical attention due to lower urinary tract symptoms, elevated prostate-specific antigen, normal digital rectal examination, and negative trbp, as urology consultation outpatients at the Hospital General de México.

Results: In the group of patients at high risk for prostate cancer that underwent trbp, 121 (96.03%) had a negative prostate cancer diagnosis after turp. Another 5 (3.97%) patients had a positive prostate cancer diagnosis after turp, even though the previous transrectal biopsy was negative. Two patients (40%) had a Gleason score of 6, and one patient (20%) had a Gleason score of 7, one patient (20%) had a score of 9, and one patient (20%) had a score of 10. In the group of patients at low risk for prostate cancer that were not candidates for trbp, but that presented with lower urinary tract symptoms, 111 (88.09%) had a negative prostate cancer diagnosis after turp. An additional 15 (11.91%) had a positive prostate cancer diagnosis after turp, 7 (46.7%) of whom had a Gleason score of 7, 3 (20%) had a Gleason score of 6,  3 (20%) had a score of 9, one (6.7%) had a score of 8, and one (6.7%) had a score of 10.

Conclusions: Patients detected with prostate cancer through turp represent a diverse group in whom the procedure can be both diagnostic and therapeutic. Our study showed it to be a useful diagnostic tool that can improve prostate cancer detection in isolated and specific cases. However, it should be emphasized that turp alone, performed solely for diagnostic purposes, is not recommended.