Korean J Urol.  2010 Feb;51(2):101-105.

Safety and Efficacy of Combined Transrectal Ultrasound-Guided Prostate Needle Biopsy and Transurethral Resection of the Prostate

Affiliations
  • 1Department of Urology, Eulji University School of Medicine, Seoul, Korea. ytk5202@eulji.ac.kr

Abstract

PURPOSE: This study was conducted to examine whether simultaneous transrectal prostate needle biopsy (TPNB) owing to an increase in prostate-specific antigen (PSA) levels is safe and effective in patients who are scheduled for transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS
Combined TPNB and TURP was performed in a total of 42 patients aged 60 years and older who had gray-zone PSA values (4-10 ng/ml) and PSA density (PSAD) values of 0.12 and less. The frequencies of fever, sepsis, and epididymitis were assessed after surgery. The diagnostic accuracy was assessed, and the results of histologic examination were evaluated in terms of TPNB or TURP. In addition, the diagnostic accuracy was assessed according to age.
RESULTS
Prostate cancer was diagnosed in 6 (14.3%) of the 42 patients: 2 patients were diagnosed with prostate cancer by TPNB only, 3 patients by TURP only, and 1 patient by combined TPNB and TURP. Four (25%) of the 16 patients aged under 70 years and 2 (7.8%) of the 26 patients aged 70 years and older were diagnosed with prostate cancer. Fever was observed in 9 patients (21.4%), 4 (9.5%) of whom had a fever of higher than 38degrees C. The fever normalized the day after surgery in all 9 patients. No septicemia was noted. There were no serious complications related to combined TPNB and TURP.
CONCLUSIONS
The results of this study suggest that combined TPNB and TURP may be safe and effective in patients who require TURP.

Keyword

Prostatic hyperplasia; Prostatic neoplasms; Biopsy; Transurethral resection of prostate

MeSH Terms

Aged
Biopsy
Biopsy, Needle
Epididymitis
Fever
Humans
Male
Needles
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia
Prostatic Neoplasms
Sepsis
Transurethral Resection of Prostate
Prostate-Specific Antigen

Reference

1. Catalona WJ, Richie JP, Ahmann FR, Hudson MA, Scardino PT, Flanigan RC, et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men. J Urol. 1994; 151:1283–1290. PMID: 7512659.
Article
2. Park HK, Hong SK, Byun SS, Lee SE. Comparison of the rate of detecting prostate cancer and the pathologic characteristics of the patients with a serum PSA level in the range of 3.0 to 4.0 ng/ml and the patients with a serum PSA level in the range 4.1 to 10.0 ng/ml. Korean J Urol. 2006; 47:358–361.
3. Lee SC, Lee SC, Kim WJ. Value of PSA density, PSA velocity and percent free PSA for detection of prostate cancer in patients with serum PSA 4-10 ng/ml patients. Korean J Urol. 2004; 45:747–752.
4. Lee SJ, Seo IY, Kim JS, Rim JS. The effectiveness of free/total prostate specific antigen (PSA) ratio for increasing the detection rate of prostate cancer in patients with serum PSA level 4-10ng/ml. Korean J Urol. 2001; 42:815–820.
5. Lee TK, Chung TG, Kim CS. Age-specific reference ranges of prostate specific antigen from a health center in Korea. Korean J Urol. 1999; 40:583–588.
6. Kim BK, Chang SH, Kim CI. Clinical significance of prostate-specific antigen density in patients with serum prostate specific antigen between 4 and 10 ng/ml. Korean J Urol. 2006; 47:1161–1165.
7. Rommel FM, Agusta VE, Breslin JA, Huffnagle HW, Pohl CE, Sieber PR, et al. The use of prostate specific antigen and prostate specific antigen density in the diagnosis of prostate cancer in a community based urology practice. J Urol. 1994; 151:88–93. PMID: 7504748.
Article
8. Zisman A, Leibovici D, Kleinmann J, Siegel YI, Lindner A. The impact of prostate biopsy on patient well-being: a prospective study of pain, anxiety and erectile dysfunction. J Urol. 2001; 165:445–454. PMID: 11176394.
9. Jones JS, Ulchaker JC, Nelson D, Kursh ED, Kitay R, Angie S, et al. Periprostatic local anesthesia eliminates pain of office-based transrectal prostate biopsy. Prostate Cancer Prostatic Dis. 2003; 6:53–55. PMID: 12664066.
Article
10. Kobayashi T, Mitsumori K, Kawahara T, Nishizawa K, Ogura K, Ide Y. Prostate gland volume is a strong predictor of biopsy results in men 70 years or older with prostate-specific antigen levels of 2.0-10.0 ng/mL. Int J Urol. 2005; 12:969–975. PMID: 16351653.
Article
11. Autorino R, De Sio M, Di Lorenzo G, Damiano R, Perdona S, Cindolo L, et al. How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature. J Urol. 2005; 174:2091–2097. PMID: 16280735.
Article
12. Cha KS, Lee SW, Cho JM, Kang JY, Yoo TK. Efficacy and safety of intravenous propofol anesthesia during transrectal ultrasound-guided prostate biopsy. Korean J Urol. 2009; 50:757–761.
Article
13. Shen BY, Chang PL, Lee SH, Chen CL, Tsui KH. Complications following combined transrectal ultrasound-guided prostate needle biopsies and transurethral resection of the prostate. Arch Androl. 2006; 52:123–127. PMID: 16443589.
Article
14. Gustafsson O, Norming U, Nyman CR, Ohström M. Complications following combined transrectal aspiration and core biopsy of the prostate. Scand J Urol Nephrol. 1990; 24:249–251. PMID: 2274747.
15. Rietbergen JB, Kruger AE, Kranse R, Schröder FH. Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology. 1997; 49:875–880. PMID: 9187694.
Article
16. Palisaar JR, Wenske S, Sommerer F, Hinkel A, Noldus J. Open radical retropubic prostatectomy gives favourable surgical and functional outcomes after transurethral resection of the prostate. BJU Int. 2009; 104:611–615. PMID: 19298408.
Article
17. Gohji K, Nomi M, Egawa S, Morisue K, Takenaka A, Okamoto M, et al. Detection of prostate carcinoma using prostate specific antigen, its density, and the density of the transition zone in Japanese men with intermediate serum prostate specific antigen concentrations. Cancer. 1997; 79:1969–1976. PMID: 9149025.
Article
18. Zheng XY, Xie LP, Wang YY, Ding W, Yang K, Shen HF, et al. The use of prostate specific antigen (PSA) density in detecting prostate cancer in Chinese men with PSA levels of 4-10 ng/ml. J Cancer Res Clin Oncol. 2008; 134:1207–1210. PMID: 18446367.
19. Puppo P, Introini C, Calvi P, Naselli A. 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. Eur Urol. 2006; 49:873–878. PMID: 16439052.
Article
20. Cho KJ, Ha US, Lee CB. Role of transurethral resection of the prostate in the diagnosis of prostate cancer for patients with lower urinary tract symptoms and serum PSA 4-10 ng/ml with a negative repeat transrectal needle biopsy of prostate. Korean J Urol. 2007; 48:1010–1015.
21. Oesterling JE, Cooner WH, Jacobsen SJ, Guess HA, Lieber MM. Influence of patient age on the serum PSA concentration. An important clinical observation. Urol Clin North Am. 1993; 20:671–680. PMID: 7505975.
22. Dalkin BL, Ahmann FR, Kopp JB. Prostate specific antigen levels in men older than 50 years without clinical evidence of prostatic carcinoma. J Urol. 1993; 150:1837–1839. PMID: 7693980.
Article
23. Anderson JR, Strickland D, Corbin D, Byrnes JA, Zweiback E. Age-specific reference ranges for serum prostate-specific antigen. Urology. 1995; 46:54–57. PMID: 7541586.
Article
24. Choi YD, Kang DR, Nam CM, Kim YS, Cho SY, Kim SJ, et al. Age-specific prostate-specific antigen reference ranges in Korean men. Urology. 2007; 70:1113–1116. PMID: 18158029.
Article
25. Meshref AW, Bazinet M, Trudel C, Aronson S, Peloquin F, Nachabe M, et al. Role of prostate-specific antigen density after applying age-specific prostate-specific antigen reference ranges. Urology. 1995; 45:972–979. PMID: 7539562.
Article
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr