Prostate specific antigen in male patients over 40 years with prostatism at Kenyatta National Hospital

Abstract

Objective : To co-relate clinical features of protatism with plasma prostate specific antigen (PSA) in male patients at Kenyatta National Hospital (KNH) Setting: KNHurological clinics and urological wards Nairobi Kenya. Materials and Methods: Thisis a prospective study undertaken at KNHbetween July 2005 and November2005 to evaluate male patients over 40 years who presented withsymptoms and signs ofprostatism. The symptom severity was scored usmg the international prostate symptom score (IPSS). The result of prostate specific antigen assay done within six months and other investigations for prostatism namely abdominal ultrasound, cystoscopy and pelvic x ray were looked at. Reports ofprostate histology which were obtained from trucut biopsy or after prostatectomy were evaluated to verify the true diagnosis of a specificprostate disease ofthe study subject. The prostate histology specimen was processed using the standard procedure and was reported by the hospital pathologist .The conventional PSAcutoff of 4ngjml was used to group the subjects into high total serum PSAsubjects and normal total serum PSAsubjects. RESULTS: Atotal of74 patients aged between 40 years and 95 years were enrolled in the study with an average age of68.78 years. The symptoms severity of each patient was scored usmg IPSS and ranged between 5 and 33. Majority of the study subject had a score of more than 20 which represented severe disease. Of those with a high IPSS, 76.4% had a raised total serum PSA.