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Related Concept Videos

Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...

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Related Experiment Video

Updated: Jun 23, 2026

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
05:35

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance

Published on: June 6, 2025

Repeat prostate biopsy--when, where, and how.

Joseph C Presti1

  • 1Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA. jpresti@stanford.edu

Urologic Oncology
|May 6, 2009
PubMed
Summary

A persistently rising PSA after a negative biopsy necessitates repeat prostate biopsies. Optimizing technique with 14 cores and considering saturation biopsy improves cancer detection.

Area of Science:

  • Urology
  • Oncology
  • Medical Diagnostics

Background:

  • Elevated or rising PSA levels after a negative prostate biopsy cause patient and urologist stress.
  • Assessing initial biopsy adequacy is crucial for patients with prior negative results.

Purpose of the Study:

  • To review indications and techniques for repeat prostate biopsies in patients with persistently elevated PSA.
  • To highlight strategies for improving cancer detection rates in repeat biopsies.

Main Methods:

  • Review of current literature on repeat prostate biopsy indications and techniques.
  • Discussion of PSA (prostate-specific antigen) and emerging markers like PCA3.
  • Recommendations for biopsy core number and targeted areas, including anterior apex.

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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound

Published on: March 21, 2025

Related Experiment Videos

Last Updated: Jun 23, 2026

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
05:35

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance

Published on: June 6, 2025

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
06:08

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound

Published on: March 21, 2025

Main Results:

  • Free/Total PSA (F/T PSA) is a key predictor for cancer in repeat biopsies.
  • Newer markers like PCA3 show promise for improved detection.
  • A minimum of 14 cores, including anterior apex, is recommended for repeat biopsies.

Conclusions:

  • Repeat prostate biopsy is indicated for persistently rising PSA despite negative initial results.
  • Optimized biopsy techniques, including increased core numbers and targeted sampling, enhance cancer detection.
  • Saturation biopsies should be considered when clinical suspicion remains high after negative repeat biopsies.