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Related Experiment Video

Updated: Jun 13, 2026

Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking
05:49

Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking

Published on: October 10, 2019

Is extended and saturation biopsy necessary?

Vincenzo Scattoni1, Carmen Maccagnano, Giuseppe Zanni

  • 1Department of Urology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy. scattoni.vincenzo@hsr.it

International Journal of Urology : Official Journal of the Japanese Urological Association
|April 27, 2010
PubMed
Summary

The outdated sextant scheme for prostate biopsy is obsolete. Modern techniques use enhanced local anesthesia and extended core protocols for improved prostate cancer detection.

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Area of Science:

  • Urology
  • Oncology
  • Surgical Techniques

Background:

  • The traditional Hodge sextant scheme for prostate biopsy is no longer optimal.
  • Advancements in local anesthesia have enabled more extensive biopsy protocols.
  • Improved pain management is crucial for patient tolerance of increased core sampling.

Purpose of the Study:

  • To outline updated prostate biopsy techniques.
  • To emphasize the importance of local anesthesia in modern prostate biopsy.
  • To define optimal extended and saturation biopsy protocols.

Main Methods:

  • Implementing peri-prostatic nerve block with lidocaine as the gold standard for pain management.
  • Adopting an extended protocol including the sextant template plus 4-6 additional lateral and medial cores.

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Last Updated: Jun 13, 2026

Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking
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Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking

Published on: October 10, 2019

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  • Utilizing saturation biopsies (≥20 cores) for repeat procedures with high cancer suspicion.

    • Main Results:

    • Peri-prostatic nerve block provides superior pain relief during prostate biopsy.
    • Extended protocols improve sampling accuracy compared to the obsolete sextant scheme.
    • Saturation biopsies are reserved for specific high-suspicion repeat cases.

    Conclusions:

    • The sextant scheme for prostate biopsy is obsolete and should be replaced by extended protocols.
    • Peri-prostatic nerve block with lidocaine is the recommended anesthesia for prostate biopsy.
    • Further evaluation is needed for complementary imaging methods to enhance biopsy accuracy.