• Meta-Analysis as Topic
• Prevalence; Risk Factors
• Prostatic Hyperplasia

• Humans
• Laser Therapy/adverse effects
• Laser Therapy/methods
• Lasers, Solid-State/therapeutic use
• Male
• Prevalence
• Prostate-Specific Antigen
• Prostatic Hyperplasia/surgery
• Prostatic Neoplasms/diagnosis
• Prostatic Neoplasms/surgery
• Risk Factors
• Transurethral Resection of Prostate/adverse effects
• Transurethral Resection of Prostate/methods
• Treatment Outcome

• prostatic cancer
• multiplex immunohistochemistry
• core biopsy

• Biomarkers, Tumor/metabolism
• Biopsy, Large-Core Needle
• Eosine Yellowish-(YS)
• Hematoxylin
• Humans
• Immunohistochemistry
• Ki-67 Antigen
• Male
• Prospective Studies
• Prostate/pathology
• Prostatic Neoplasms/pathology
• Racemases and Epimerases

The aim of this study is to investigate the incidental prostate cancer (iPCa) detection rates of different embedding methods in a large, contemporary cohort of patients with bladder outlet obstruction (BOO) treated with transurethral surgery. We relied on an institutional tertiary-care database to identify BOO patients who underwent either transurethral loop resection or laser (Holmium:yttrium–aluminium garnet) enucleation of the prostate (HoLEP) between 01/2012 and 12/2019. Embedding methods differed with regard to the extent of the additional prostate tissue submitted following the first ten cassettes of primary embedding (cohort A: one [additional] cassette/10 g residual tissue vs. cohort B: complete embedding of the residual tissue). Detection rates of iPCa among the different embedding methods were compared. Subsequently, subgroup analyses by embedding protocol were repeated in HoLEP-treated patients only. In the overall cohort, the iPCa detection rate was 11% (46/420). In cohort A (n = 299), tissue embedding resulted in a median of 8 cassettes/patient (range 1–38) vs. a median of 15 (range 2–74) in cohort B (n = 121) (p < .001). The iPCa detection rate was 8% (23/299) and 19% (23/121) in cohort A vs. cohort B, respectively (p < .001). Virtual reduction of the number of tissue cassettes to ten cassettes resulted in a iPCa detection rate of 96% in both cohorts, missing one stage T1a/ISUP grade 1 carcinoma. Increasing the number of cassettes by two and eight cassettes, respectively, resulted in a detection rate of 100% in both cohorts without revealing high-grade carcinomas. Subgroup analyses in HoLEP patients confirmed these findings, demonstrated by a 100 vs. 96% iPCa detection rate following examination of the first ten cassettes, missing one case of T1a/ISUP 1. Examination of 8 additional cassettes resulted in a 100% detection rate. The extent of embedding of material obtained from transurethral prostate resection correlates with the iPCa detection rate. However, the submission of 10 cassettes appears to be a reasonable threshold to reduce resource utilization while maintaining secure cancer detection.

• HoLEP
• Holmium laser enucleation
• Incidental prostate cancer
• Prostate cancer
• TUR-P
• Transurethral resection of the prostate

• Prostate cancer
• Robot-assisted radical prostatectomy
• Transurethral resection of the prostate

• HGPIN
• Incidental adenocarcinoma
• Prostatectomy
• prostate cancer

• Benign prostatic hyperplasia
• Holmium laser enucleation of the prostate (HoLEP)
• Incidental prostate cancer
• Lower urinary tract symptoms

• Ablation therapy
• Benign prostatic hyperplasia
• Convective energy source
• Lower urinary tract symptoms
• Minimally invasive treatment
• Rezum
• Thermal energy
• Water vapour therapy

Persistent suspicion of prostate cancer (PCa) due to a rising prostate-specific antigen (PSA) level after repeated negative biopsies is a serious challenge in clinical practice.

To determine the role of Hiraoka’s transurethral detachment of the prostate (TUDP) combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of PCa.

We retrospectively evaluated the records of 10 patients who were eligible for inclusion in our hospital between December 2012 and August 2017. Patient demographics, a family history of PCa, the number of biopsies, prostate volume, pathological examination, and perioperative PSA level were obtained.

Two of 10 patients were pathologically diagnosed with PCa after surgery; the Gleason scores were 4 + 4 and 4 + 3, respectively. Both patients subsequently underwent laparoscopic radical prostatectomy. The median PSA levels preoperatively, and 3 mo and 1 year postoperatively in the other eight patients who were diagnosed with benign prostate hyperplasia after surgery were 19.10 ng/mL, 1.10 ng/mL, and 1.15 ng/mL, respectively. The adjusted P values of the 3-mo and 1-year post-operative PSA level vs pre-operative PSA level were 0.003 and 0.026, respectively. None of the patients had increased PSA levels or PCa detected after a median 35 mo of follow-up.

TUDP combined with peripheral zone biopsy may improve the detection rate of PCa in patients with repeated negative biopsies. The PSA level declined rapidly in patients who had negative pathological examinations after TUDP, which remained stable 1 year after surgery.

• Prostate cancer
• Biopsy
• Transurethral detachment of prostate
• Transurethral resection of the prostate
• Prostate-specific antigen
• Hiraoka’s transurethral detachment of the prostate

• Benign prostatic hyperplasia
• Photoselective vaporization
• Prostate cancer
• Prostate-specific antigen

The aim of this study was to evaluate predictors of residual tumor and clinical prognosis in T1a-T1b (incidental) prostate cancer by analysis of specimens from men undergoing surgery for benign prostatic hyperplasia.

We retrospectively reviewed medical records of incidental prostate cancer patients who had undergone radical prostatectomy. Patients whose tumor statuses were further confirmed by prostate biopsy, or who had used androgen deprivation therapy before radical prostatectomy, were excluded. Clinical and pathological parameters were analyzed to evaluate residual tumor and clinical prognosis. We used univariate and multivariate logistic regression analyses, as well as receiver operator characteristics, to predict residual tumor (pT0).

The final analysis included 95 patients. Among these patients, 67 (70.53%) exhibited residual tumor, whereas 28 (29.47%) did not (pT0). Pathology findings showed that 44 (65.67%), 16 (23.88%), and 7 patients (10.45%) exhibited Gleason scores of G6, G7, and ≥G8, respectively. Fifty-seven and 10 patients exhibited pathologic T stages T2 and T3, respectively. Mean follow-up duration was 70.26 (±34.67) months. Biochemical recurrence was observed in 11 patients; none were pT0 patients. Multivariate logistic regression showed that low prostate-specific antigen density after benign prostatic hyperplasia surgery and invisible lesion on multiparametric magnetic resonance imaging were significantly associated with pT0. Additionally, a combination of these factors showed an increase in the diagnostic accuracy of pT0, compared with mpMRI alone (AUC 0.805, 0.767, respectively); this combination showed sensitivity, specificity, and positive predictive values of 71.6%, 89.3%, and 94.1%, respectively.

Our results suggest that patients with incidental prostate cancer who have both prostate-specific antigen density ≤0.08 after benign prostatic hyperplasia surgery as well as invisible cancer lesion on multiparametric magnetic resonance imaging should be considered for active surveillance.

• Aged
• Disease-Free Survival
• Follow-Up Studies
• Humans
• Incidence
• Kallikreins/blood
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasm Staging
• Prostate-Specific Antigen/blood
• Prostatectomy
• Prostatic Neoplasms/blood
• Prostatic Neoplasms/diagnostic imaging
• Prostatic Neoplasms/mortality
• Prostatic Neoplasms/surgery
• Retrospective Studies
• Survival Rate

Prostatic carcinoma carries a high morbidity and mortality if it is not diagnosed early. In resource limited countries, patients are at increased risk of being diagnosed late as they are operated for presumed benign prostatic hyperplasia. The information on the magnitude and risk factors of this problem in our setting could assist in the overall optimization of care of patients at risk.

A retrospective study of patients who underwent prostatectomy for presumed benign prostatic enlargement was done at Bugando University Hspital in Tanzania. Patients' age, creatinine levels, urological Ultrasound, prostate specific antigen and Biopsy results were analyzed using STATA 11. The prevalence of incidental prostatic cancer was calculated and logistic regression was done for factors associated with incidental prostatic cancer.

In total, 152 patients were included in this study. The median age was 69 (SD 9.4) years, 16 (10.53%,) and 49 (32.24%) participants had Hydronephrosis and elevated creatinine levels respectively. Eighty six (58.56%) patients had PSA >10 ng/mL and in total; 33 (21.71%) had incidental prostatic carcinoma. The incidental prostatic carcinoma was independently associated with age of 70– 80years (AOR=2.8, p = 0.013) and PSA levels >10ng/mL (AOR=3.2, p=0.014).

The prevalence of incidental prostatic carcinoma is high among patients undergoing transurethral prostatectomy for presumed benign prostatic hyperplasia in Tanzania with increased risk at age of 70–80 years and among those with PSA >10ng/mL. A national awareness campaign coupled with focused screening of patients above 60 years could increase the detection rate of prostatic carcinoma and reduce the magnitude of incidental diagnosis of this disease.

• Incidental prostatic carcinoma
• PSA
• Tanzania
• Tertiary level hospital

• expression
• miR-15/16 cluster
• prostate cancer
• real-time polymerase chain reaction

• Iran
• incidental prostate cancer
• open prostatectomy
• prostate cancer
• transurethral resection of the prostate

Bladder outlet obstruction due to prostate enlargement is a common health problem in male and frequently investigated with prostate-specific antigen (PSA) and transrectal ultrasound (TRUS). TRUS-guided biopsy is critical to differentiate benign prostatic hyperplasia (BPH) or prostate cancer (PCa) even though it has been associated with false negative with reported 3%–16% incidence of PCa in BPH specimens. Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT), a targeted molecular imaging for PCa, has showed promising results in recurrence and staging. We analyzed its role in patients with abnormal PSA and benign TRUS biopsy.

Of 558 ⁶⁸Ga-PSMA PET/CT performed from July 2014 to February 2017, we found six patients with abnormal PSA (range 8.2–24.2 ng/ml, median: 13.3 ng/ml) with benign 12 cores TRUS biopsy as indication. These cases were reanalyzed in detail. Spearman's rank test was used entire correlation using SPSS version 21.

⁶⁸Ga-PSMA PET/CT showed mild diffuse tracer uptake in prostate in all patients with no focality and maximum standard uptake value normalized to body weight (SUV_max) range was 3.2-5.8 (median: 3.9). Two patients with PSA <10 ng/ml had normal ⁶⁸Ga-PSMA PET/CT and underwent medical management. In other four patients with PSA >10 ng/ml, two showed metastatic disease in pelvic lymph node in both and in lung in one; hence, ⁶⁸Ga-PSMA PET/CT changed these patients' management. Spearman's rank test showed no correlation with baseline PSA and SUV_max of prostate (r_s −0.0287, P = 0.9571) while strong positive correlation was seen with baseline PSA and ⁶⁸Ga-PSMA PET/CT scan positivity for extraprostatic disease (r_s = 0.828, P = 0.042).

⁶⁸Ga-PSMA whole-body PET/CT can provide useful incremental information in patient with high PSA and negative TRUS biopsy and has a potential to guide management in this subgroup of PCa patients.

• 68-gallium-prostate-specific membrane antigen positron emission tomography/computed tomography
• abnormal prostate-specific antigen
• benign prostatic hyperplasia
• lung metastasis
• negative 12 cores transrectal ultrasound biopsy

Operative management of prostate cancer in a patient who has undergone previous open suprapubic simple prostatectomy poses a unique surgical challenge. Herein, we describe a case of intermediate risk prostate cancer in a man who had undergone simple prostatectomy ten years prior to presentation. The patient was found to have Gleason 7 prostate cancer on MRI fusion biopsy of the prostate for elevated PSA and underwent an uncomplicated robot assisted laparoscopic radical prostatectomy.