Retrospective review of clinical and pathological pattern of prostatic diseases: a reminder to clinicians on an increased clinical vigilance, an experience from central, Tanzania.


  • Masumbuko Y Mwashambwa Department of General Surgery College of Health Sciences, P. O. Box 395, Dodoma, Tanzania
  • Athanase G Lilungulu
  • Afred J Meremo
  • Martin McCann
  • Ainory P Gesase



Prostatic diseases, presenting symptoms, histology, prostatectomy, tumor extent and Gleason’s sum


Introduction: Prostatic diseases are a very common in men over 40 years of age and pose a significant risk in terms of morbidity and mortality. Globally, benign prostatic hyperplasia (BPH), prostatic cancer and prostatitis are the most common conditions mainly presenting with lower urinary symptoms or symptoms related to complications of urinary bladder obstruction. Despite the relatively high prevalence of prostatic diseases, there is paucity of literature on in most developing countries, East Africa inclusive. The aim of this study was therefore to conduct a retrospective review of all prostatic biopsies submitted to private histopathology laboratory in Central, Tanzania in order to understand the clinical and histological pattern of the diseases.

Methodology: This was a retrospective laboratory-based descriptive study. The study involved review of the available prostatic biopsy database for a period of one year, from February 2014 to February 2015.

Results: Benign prostatic hyperplasia (61.6%) and prostate cancer (28.3%) are the most prevalent clinical diagnoses. They often presented with lower urinary tract symptoms (45.5%) and urinary retention (41.5%), although a significant proportion of cases were missing clinical information (10.1%). Histologically, BPH was the most common prostatic disease (60%), followed by prostate cancer (24.1%) and prostatitis (15.9%). The likelihood of making correct clinical diagnosis of BPH and cancer of prostate was consistently low (66.3% and 51.9% respectively). Despite clinical suspicion of prostatic cancer, there was high preponderance by clinicians to perform prostatectomy (80%), contrary to standard recommendation. Most histologically confirmed prostatic cancer had unfavorable scores in terms of histological extent of tumor (63.6%) and Gleason’s sum (92.9%).

Conclusion: This study has demonstrated that clinical and histological patterns of prostatic diseases are similar to other studies, most of which are presenting with lower urinary tract symptoms and urinary retention. The accuracy of clinical diagnosis is low and a significant number of clinically suspected cases of prostate cancer underwent surgical operation, many of whom had unfavorable prognostic scores.

Recommendations: It is recommended that clinicians should: scale up clinical vigilance and index of suspicion in dealing with cases of prostatic diseases, provide necessary information to histopathologists, and adhere to guidelines in managing prostatic cancer. Furthermore, resources for management of prostatic diseases should be increased and more studies should be conducted. 


Hsing, A.W, Tsao, L and Devesa SS. International trends and patterns of prostate cancer incidence and mortality. Int. J. Cancer (Pred. Oncol.): 2000. 85, 60–67.

Temi, A.P, Emmanuel, OA, Samuel, A.A, Olufemi, A.P, Akande, A.O, Joshua, T..O, Olusanmi, E.J, Olufemi, O.W. Prevalence of Clinico-histologically diagnosed Prostatic Diseases: Experience from a budding Tertiary Centre. The Journal for Urology. 2015. 112: 130-138.

Mohammed, A.Z, Nwana E.J.C, Anjorin, A.S. Histopathological pattern of prostatic diseases in Nigerians. African Journal of Urology. 2005. 11(1): 33-38.

Garg, M, Kaur, G, Malhotra, V, and Garg, R. Histopathological spectrum of 364 prostatic specimens including immunohistochemistry with special reference to grey zone lesions. Prostate Int; 2013.1(4): 146–151.

Randall A. Surgical Pathology of Prostatic Obstruction. Baltimore: Williams & Wilkins.1931.

Harbitz TB, Haugen OA. Histology of the prostate in elderly men: a study in an autopsy series. Acta Pathol Microbiol Immunol Scand [A]; 1972. 80:756–777.

Center M.M, Jemal A, Lortet-Tieulent, J, Ward E, Ferlay J, Brawley O, Bray F. International Variation in Prostate Cancer Incidence and Mortality Rates. European Urology. 2012. 61, (6), 1079–1092.

Roberts RO, Jacobsen SJ. Epidemiology of Prostatitis. Current Urology Reports 1 (2): 135-141. 2000.

Blaivas, J.G. Urinary symptoms and symptom scores. J Urol. 1993; 150(5 pt 2):1714.

Jepsen, J.V, Bruskewitz, R.C. Clinical manifestation and indications for treatment in prostatic diseases. In: Lepor H, editor. Prostatic Diseases. Philadelphia: WB Saunders Company; 2000. 127–142.

McVary, K.T. Clinical Evaluation of Benign Prostatic Hyperplasia. Rev Urol. 2003; 5(Suppl 4): S3–S11.

Murray, T., Bolden, S., Wingo, P.A. Cancer statistic.CA Cancer J. Clin. 1999. 49(1), 8-31.

Anushree, C.N., Kusuma V. Morphological spectrum of prostatic lesions – a clinicopathological study. Medica Innovatica. 2012. 1(2), 49-54.

Klotz, L. Active surveillance with selective delayed intervention for favorable risk prostate cancer. Urol Oncol, 2006. 24: 46.

Hardie, C., Parker, C., Norman, A., Eeles, R., Horwich, A., Huddart, R. Early outcomes of active surveillance for localized prostate cancer. Br J Urol Int. 2005. 95: 956

Warlick, C., Trock, B. J., Landis, P., Epstein, J. I. and Carter, H. B. Delayed versus immediate surgical intervention and prostate cancer outcome. J Natl Cancer Inst, 2006. 98: 355.

Blasko, J. C., Ragde, H. and Grimm, P. D. Transperineal ultrasound-guided implantation of the prostate: morbidity and complications. Scand J Urol Nephrol Suppl, 1991. 137: 113.

Sylvester, J. E., Blasko, J. C., Grimm, P. D., Meier, R. and Malmgren, J. A. Ten-year biochemical relapse-free survival after external beam radiation and brachytherapy for localized prostate cancer: the Seattle experience. Int J Radiat Oncol Biol Phys, 2003. 57: 944.

Walsh, P.C. Patient-reported impotence and incontinence after nerve-sparing radical prostatectomy. J Urol, 1998. 159: 308.

Aus, G. Current status of HIFU and cryotherapy in prostate cancer – a review. Eur Urol, 2006. 50:927.

American Urology Association: Guidelines for management of clinically localized prostatic cancer. 2007.

Nickel, JC, Méndez-Probst, CE, Whelan, TF Paterson, RF, Razvi, H. Guidelines for the management of benign prostatic hyperplasia. Can Urol Assoc J 2010;4(5):310-316.

Mosli H.A., Abdel-Meguid T.A., Kamak W.K., Saadah H.A., Farsi H.M. The clinicopathologic pattern of prostatic diseases and Pca in Saudi patients. Saudi Med J. 2009. 30(11), 1439-43.

Brawley O.W. Prostate cancer epidemiology in the United States. World Journal of Urology: 2012. 30,(2), 195-200.

Shimizu, H. Ross, R.K. Bernstein, L. Yatani, R. Henderson, B and Mack T.M. Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County. Br J Cancer. 1991. 63(6): 963–966.

Wilt, TJ. (2003). Prostate Cancer: Epidemiology and Screening. Rev Urol. 2003; 5(Suppl 6): S3–S9.

Xia S, Cui D, Jiang Q. An overview of prostate diseases and their characteristics specific to Asian men. Asian J Androl. 2012. 14(3): 458–464






Original Research

How to Cite

Retrospective review of clinical and pathological pattern of prostatic diseases: a reminder to clinicians on an increased clinical vigilance, an experience from central, Tanzania. (2017). Tanzania Medical Journal, 27(1), 70-82.

Similar Articles

1-10 of 90

You may also start an advanced similarity search for this article.