Role of Transurethral Resection of the Prostate and Biopsy of the Peripheral Zone in the Same Session after Repeated Negative Biopsies in the Diagnosis of Prostate Cancer

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Abstract

Objective:

To determine the role of the transurethral resection of the
prostate (TURP) together with biopsies of the peripheral zone in the
diagnosis of prostate cancer after repeated negative transrectal biopsies
and increasing prostate-specific antigen (PSA) levels.

Methods:

From 2003 to 2004, 43 patients, aged 53–69 yr, were seen for a
history of at least two negative biopsies for prostate cancer. Thirty-five
men had an increasing PSA level and underwent another set of biopsies.
Seven patients had prostate cancer (20%); three were lost at follow-up
and four had a Charlson comorbidity index >1. The remaining 21 were
offered TURP and biopsy of the peripheral zone. Bladder outlet obstruction
had no influence on decision-making. Fourteen men accepted.

Results:

Eight patients (57%) had prostate cancer and underwent radical
prostatectomy. Six cancers were detected only with TURP, one with
TURP and biopsy, and one with biopsy alone. After a median of 9 mo
of follow-up, two of six patients underwent rebiopsy for a rising PSA
level, but no cancer was detected.

Conclusions:

TURP combined with a set of transrectal needle biopsies of
the lateral portion of the gland is a safe procedure with a high diagnostic
power after repeated negative biopsies in patients with persistently
increasing PSA levels.
# 2005 Elsevier B.V. All rights reserved.

Article info

Article history:
Accepted December 16, 2005
Published online ahead of print on January 18, 2006

Keywords:
Prostatic cancer
Needle biopsy
Transurethral resection of
prostate

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