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[Diagnostic value of 10 systematized and ultrasound-guided transrectal prostatic biopsies]
V Ravery1, T Billebaud, M Toublanc
1Service d'Urologie, Hôpital Bichat, Paris, France.
Objective:
To study the improvement of prostatic cancer detection provided by ten strictly systematized transrectal prostatic biopsies.
Material And Methods:
This prospective study was conducted in 162 patients submitted to a series of 10 ultrasound-guided transrectal prostatic biopsies due to the presence of elevated PSA and/or an abnormality on digital rectal examination. Five biopsies were taken from different sites in each lobe: 2 biopsies were inserted between the 3 biopsies usually performed in the standard protocol, while maintaining the angle of entry of the needle recommended in this protocol.
Results:
The complication rate was 1.85% with the 10-biopsy technique. Prostatic cancer was detected in 40.1% of the 162 patients. The percentage diagnostic improvement provided by the 10-biopsy protocol in the overall patient population was +3.1% compared to the standard protocol. The highest percentage diagnostic improvement was observed in the group of patients with PSA < or = 10 ng/ml (+4.9%) and in the group of patients with an ultrasound prostatic volume < or = 40 cc (+4%).
Conclusion:
The most marked diagnostic improvement appears to be related more to sampling of prostatic zones presenting a statistically increased risk of cancer (peripheral zone) than to the increased number of prostatic biopsies performed.