Prevalence of Clinically Concealed Prostatic Diseases at Post Mortem; a Teaching Hospital Experience in South-South, Nigeria

Abstract

Background: Most post-mortem studies on prostate gland are limited to malignant prostatic tumours. The possibilities of finding other histological types of prostatic diseases were worth exploring bearing in mind that Nodular hyperplasia and cancer are of epidemiological importance. Aim: This study aims to determine the pattern of prostatic diseases at post-mortem among individuals not previously diagnosed with prostate disease and who died from other causes. Materials and Methods: Prostate glands at post-mortem were obtained from individuals who died from non-prostate related causes, weighed, fixed in 10% neutral buffered formalin, processed and histologically analysed. Biodata and clinical diagnoses were obtained using clinical case notes and post-mortem register. Results: The population under study were 86 adult males whose ages ranged from 30 to 85 years with a mean age of 52.71 ± 13.10 years. Ninety-three percent (93% / 80 cases) of the study population were afflicted with prostatic diseases at post-mortem. The most common lesion was nodular hyperplasia. Latent or occult adenocarcinoma followed this, prostatic intraepithelial neoplasia and Schistosomiasis in decreasing order of frequency. The frequency of occult adenocarcinoma, prostatic intraepithelial neoplasia (PIN) and nodular hyperplasia increased significantly with age (P ≤ 0.05).  The peak age for the development of occult adenocarcinoma, PIN and nodular hyperplasia was in the 6th, 8th and 6th decades respectively. Conclusion: Clinically concealed prostatic diseases are common findings at post-mortem. There is a significant increase (P ≤ 0.05) in the frequency of covert prostatic diseases (nodular hyperplasia, PIN and adenocarcinoma) with advancing age. Convert prostatic diseases especially nodular hyperplasia and prostatic carcinoma have the potentials of contributing significantly to the burden of health care and the cost of receiving treatment if the life expectancy improves in our environment in particular and Nigeria in general.