Frequency of Carcinoma Prostate in Patients Undergoing Transurethral Resection of Prostate for Clinically Benign Prostatic Hyperplasia

Abstract

Incidental carcinoma prostate refers to prostate cancer detected unexpectedly on histopathological examination of tissue resected for clinically benign prostatic hyperplasia. Despite advances in prostate-specific antigen screening, incidental carcinoma remains clinically relevant, particularly in aging populations. Data from Pakistan on this entity are limited, necessitating local evidence to guide clinical practice. Objective: To determine the frequency of incidental prostate carcinoma in patients undergoing transurethral resection of the prostate for clinically benign prostatic hyperplasia and to evaluate associated demographic and clinical factors. Methods: This descriptive cross-sectional study was conducted at the Department of Urology, Kidney Centre, Bahawal Victoria Hospital, Bahawalpur, from May to August 2025. A total of 124 male patients aged 50–80 years with clinically benign prostatic hyperplasia undergoing transurethral resection of the prostate were enrolled through non-probability consecutive sampling. Patients with prior prostate surgery, known prostate cancer, or lower urinary tract infection were excluded. Clinical data, including age, duration of symptoms, prostate size, serum prostate-specific antigen levels, smoking status, family history of prostate cancer, history of prostatitis, and obesity, were recorded. Resected specimens were examined histopathologically for prostate carcinoma. Data were analysed using SPSS version 25.0, and associations were assessed using chi-square or Fisher’s exact test, with p ≤ 0.05 considered statistically significant. Results: The mean age of patients was 64.2 ± 7.8 years. Incidental prostate carcinoma was detected in 13 patients, yielding a frequency of 10.5%. The detection rate increased significantly with advancing age, particularly in patients aged 71–80 years (p = 0.041). Carcinoma prostate was significantly associated with longer duration of symptoms (>12 months), larger prostate size (>60 g), higher serum prostate-specific antigen levels (≥3 ng/ml), and positive family history of prostate cancer. Smoking status, obesity, and history of prostatitis showed no statistically significant association. Conclusion: Incidental carcinoma of the prostate is not uncommon among Pakistani patients undergoing transurethral resection of the prostate for clinically benign prostatic hyperplasia. Advancing age, increased prostate volume, prolonged symptom duration, elevated prostate-specific antigen levels within the normal range, and family history are significant predictors. Routine histopathological evaluation of all transurethral resection specimens remains essential for early detection and optimal patient management.