Prostate Diseases in the Middle East, a Clinical and Pathological Review at King Abdullah University Hospital - Jordan

Rami Shaker AlAzab, Khaled Kairallah, Ismael Matalka, Haitham Tahat


Objective: Prostate cancer is the most commonly diagnosed cancer in western countries; its incidence/prevalence depends on many factors such as racial differences and diagnostic efforts. Benign prostatic hyperplasia prevalence on the other hand steadily increases with aging. We set out to review our institutional data as characterization of these two entities in the middle-east is warranted.

Methods: This is a retrospective frequency study, the study population included men who attended the urology clinic for prostate related complaints, divided into a biopsy group (who underwent prostate biopsy) and non-biopsy group defined as patients evaluate/ treated for benign prostate conditions and has no indication to perform prostate biopsy. We assessed the rates of cancer, benign prostate hyperplasia (BPH), prostate intra-epithelial neoplasia, diabetes, prostatitis, and overactive bladder.

Results: 2,966 patients included, mean age was 68.7 years. Benign prostate hyperplasia (BPH) found in 56%, Diabetes (DM) in 26.5%, overactive bladder (OAB) in 15.1%. Among 272 patients who underwent prostate biopsy: 28.7% had cancer (PCa, statistically significant by age, P=0.042). In the non-biopsy group (n=2,693), BPH found in 54.2 % and, Overall total Prostate Specific Antigen (tPSA) mean was 6.4 ng/ml, significantly higher with ageing, in the biopsy group (11.96 ng/ml), in PCa (15.6 ng/ml), BPH group 4.58 ng/ml, in patients who underwent TURP vs. medical therapy (11.9 Vs 3.11, as well as in OAB, abnormal digital rectal examination, lower in diabetics compared to their counterparts (P<0.001 for all these comparisons).

Conclusions: Our report comes in agreement with international literature regarding the clinical characters of BPH; OAB may cause an increase in the PSA values. Regarding prostate cancer, the percentage of patients who needed prostate biopsy and rates of biopsy-proven cancers were less than those reported in the literature with probably more aggressive behavior, more studies and data are needed to validate these findings.


Prostate Diseas, Middle East, King Abdullah University Hospital.

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