Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA.

Patients who have a persistently elevated or a rising PSA level following a prior negative prostate biopsy can be a stressful situation for both the urologist and the patient. This will be a brief review of the indications and techniques in patients undergoing a repeat biopsy. In patients with a prior negative biopsy, assessing the adequacy of the initial biopsy is important. F/T PSA is currently the most useful marker in predicting cancer on repeat biopsy although newer markers, such as PCA3, are promising. Repeat biopsies should include a minimum of 14 cores, the 12 cores recommended for an initial biopsy and 2 additional cores obtained form the right and left anterior apex. In patients for whom repeat biopsies fail to identify cancer, yet the clinical suspicion remains high, consideration for a saturation biopsy approach seems warranted.

Written by:
Presti JC Jr.   Are you the author?

Reference:
Urol Oncol. 2009 May-Jun;27(3):312-4.
doi:10.1016/j.urolonc.2008.10.029

PubMed Abstract
PMID:19414120

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