[Proposal of a new transurethral method for repeated prostatic biopsy]

Area of Science:

• Urology
• Oncology
• Medical Devices

Background:

• Iterative prostatic biopsies are crucial for diagnosing pre-cancerous lesions, suspected cancer, or true cancer.
• Patients are categorized into three groups based on prior treatments: no endoscopic resection, previous transurethral resection for benign prostatic hyperplasia (BPH), or previous radical prostatectomy (RP) for cancer.
• Clinical scenarios include high prostate-specific antigen (PSA) levels, T1c cancer, prostatic intraepithelial neoplasia (PIN), incidental T1a neoplasia, or suspected local relapse post-RP.

Purpose of the Study:

• To evaluate a new trans-urethral sampling method for prostatic biopsies.
• To assess the feasibility and efficacy of this technique in various patient groups.
• To determine if the new method can improve biopsy accuracy in challenging cases.

Main Methods:

• A novel eco-reflectant, flexible needle was used for trans-urethral prostatic sampling under endoscopic vision.
• The technique was applied to the transitional zone or prostatic fossa tissues in 28 patients.
• Biopsies were either integrative to standard randomized biopsies or selectively ultrasound-guided for suspicious areas.

Main Results:

• The trans-urethral biopsy procedure was minimally invasive and easy to perform.
• The technique proved particularly useful for sampling areas accessible trans-urethrally.
• It was also effective for obtaining biopsies from tissues with low thickness, including those in the prostatic fossa.

Conclusions:

• The new trans-urethral biopsy method is a safe and effective technique for prostatic tissue sampling.
• It offers an advantageous approach for specific patient groups and challenging anatomical locations.
• This technique can complement existing biopsy strategies for improved prostate cancer diagnosis.