Stav K.¹, Sandbank J.², Leibovici D.¹, Siegel Y.¹, Lindner A.¹, Zisman A.¹

Presented on March, 22 2007

INTRODUCTION & OBJECTIVES: To evaluate the diagnostic efficiency of saturation prostate biopsy in patients with PSA>10ng/ml, free PSA ratio<0.2 and at least 3 sets of negative biopsies (average 3.4 previous biopsy sets per patient, range 3-5).

MATERIAL & METHODS: Twenty three patients underwent saturation prostate biopsies using a transrectal approach under general or regional anesthesia. A systematic coverage of the peripheral zone was accomplished by maintaining a fixed distance between punctures (5mm.). Additionally, multiple cores were obtained from the transition zone bilaterally, bladder neck and midline according to a strict pre-planning.

RESULTS: The mean number of cores obtained per patient was 61 (range 48-75). Average PSA was 21ng/ml. (range 10.1-49). CAP (Gleason’s 3+3) was found in 3 patients (15%). CAP was established in only one core sampled from the peripheral zone in each case, occupying less than 1% of the core volume. Cancer was not diagnosed in the adjacent 8 cores taken 5mm away. Two patients were designated for watchful waiting and one patient chose radical retropubic prostatectomy. His pathological specimen contained CAP (Gleason 3+3) in less than 1% of the total prostate volume. In one case we found HGPIN that was diagnosed previously. All patients were discharged within 24h following the procedure.
Asymptomatic bacteremia was documented in one patient. Eventually, this patient underwent TURP one year later. Pathology was BPH. Two patients developed epididymitis and were treated conservatively.

CONCLUSIONS: In patients with previous multiple negative biopsies, the diagnostic rate of saturation biopsy is low (15%) and does not seem to represent a clear cut biologically significant disease.

UroToday.com Full Conference Coverage

Please log-in or register in order to submit comments.

Powered by AkoComment!