Digital examination and transrectal ultrasonography in the diagnosis of prostatic cancer

The efficiency of digital examination and transrectal ultrasonography in the diagnosis of prostatic cancer was examined in 109 untreated male patients with symptoms of urinary obstruction, including 32 cases of prostatic cancer. The sensitivity and specificity of digital examination were 69 and 79%, respectively, with an efficiency of 76%; while, the sensitivity and specificity of ultrasonography were 88 and 77%, respectively, with an efficiency of 80%. Of the 10 cases of subclinical cancer, where the patient had a clinically benign gland with histological evidence of cancer, 8 were correctly diagnosed ultrasonographically. Five of the 8 cases could be diagnosed by the presence of a focal hypoechoic lesion in the unilateral lobe of the prostate. These results indicate that transrectal ultrasonography is more efficient than digital examination for the diagnosis of prostatic cancer and that hypoechoic change is an important point for detecting such subclinical cancer on ultrasonography.