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Transperineal prostate needle biopsy guided by transurethral ultrasound in patients without a rectum
E K Seaman1, I S Sawczuk, M Fatal
1The J. Bentley Squier Urologic Clinic, Columbia Presbyterian Medical Center, Department of Urology, Columbia University, New York, USA.
Objectives:
Patients with elevated prostate-specific antigen (PSA) and no access to the rectum present a diagnostic challenge to the urologist. This study was undertaken to determine the efficacy of transperineal prostate biopsy using transurethral ultrasound guidance for the detection of prostate cancer.
Methods:
Five men status post either total colectomy or abdominoperineal resection (age range: 58 to 73 years, mean age 65.8 years) were referred to us for the evaluation of an elevated PSA (range: 5.6 to 21.4 ng/dL, mean 16.1 ng/dL). Seven procedures were performed utilizing transurethral ultrasound to guide transperineal prostate biopsies in these men.
Results:
Biopsy results revealed benign prostatic hyperplasia in 4 procedures and prostate cancer in 3 procedures.
Conclusions:
Transurethral ultrasound enables the practitioner to perform accurate sonographic assessment and precise biopsy of the prostate in such patients.