TITLE:
Transperineal Ultrasound-Guided Prostate Biopsy at National Social Insurance Fund Hospital, Essos Yaoundé: Initial Experience from a Resource-Limited Setting
AUTHORS:
Henry Kimbi Yisa, Achille Florian Kepdip, Constantin Essissima Foe
KEYWORDS:
Transperineal Prostate Biopsy, Prostate Cancer, Gleason Score, PSA (Prostate-Specific Antigen), Sub-Saharan Africa
JOURNAL NAME:
Open Journal of Urology,
Vol.16 No.9,
September
30,
2026
ABSTRACT: Background: Prostate cancer is the most frequently diagnosed malignancy and a leading cause of cancer-related mortality among men in sub-Saharan Africa. Transperineal ultrasound-guided prostate biopsy (TPUS-Bx) has emerged as a safer alternative to the traditional transrectal approach, offering significantly lower infectious complication rates and improved sampling of the anterior prostate. Objective: To describe the clinical characteristics, histopathological findings, and procedural outcomes of TPUS-Bx performed at NSIF Hospital in Yaoundé, Cameroon, over a two-year period. Methods: A retrospective review was conducted of 200 patients who underwent TPUS-Bx at NSIF Hospital between December 2023 and December 2025. Clinical data including age, PSA level, digital rectal examination (DRE) findings, histopathology, Gleason score, and complications were analyzed. Results: The mean age was 69.5 years (range: 50 - 88). The mean PSA was 500 ng/mL (range: 8.5 - 8200; median: 112 ng/mL). Abnormal DRE was found in 71% of patients. Prostate adenocarcinoma was diagnosed in 158 patients (79.0%). Among positive biopsies, 108 patients (68.4%) had Gleason 7 or higher, with Gleason 7 in 35 patients (22.1%), Gleason 8 in 40 patients (25.3%), and Gleason 9 - 10 in 33 patients (20.9%). Gleason 6 was found in only 50 patients (31.6%). The overall complication rate was 6.5%, with hematuria (4.0%) being the most common. No cases of sepsis or severe infection occurred. Conclusion: TPUS-Bx at NSIF Hospital demonstrates a high cancer detection rate (79.0%) with a favorable safety profile, including zero infectious complications. The predominance of Gleason 7 and above (68.4%) in a cohort with extremely elevated PSA levels (mean 500 ng/mL) confirms that Cameroonian men present with aggressive, high-risk prostate cancer, consistent with the high mortality rates observed in African populations. TPUS-Bx should be considered the preferred approach for prostate biopsy in resource-limited settings.