Microscopic foci of cancer in prostatectomy for benign disease: diagnostic and surgical considerations.

A study of 66 patients in whom microscopic foci of prostatic cancer was found in prostatectomies done for benign prostatic hyperplasia revealed in 32 of the 66 cases (48%) that there were in retrospect abnormal rectal findings that should have suggested the possibility of neoplasia. Other abnormalities were elevated serum acid phosphatase (5 patients), asymmetrical enlargement of one lateral prostatic lobe at cystoscopy (7 patients), and unilateral hydroureteronephrosis (7 patients). Urinary retention was the presenting symptoms in 56% of the patients. Difficult enucleation was noted in 41% of the open prostatectomies. The importance of performing careful prostatic biopsy in any suspicious prostatic enlargement is again stressed.