Role of the transurethral resection of the prostate together with biopsies of the peripheral zone in the diagnosis of prostate cancer after repeated negative transrectal biopsies and increasing PSA levels

 

Persistently increasing PSA and repeated negative prostate biopsies is a major problem for the urologist and a nightmare for the patient. After the second negative prostate biopsy, the chance to find prostate cancer decreases under 10% and there is no general consensus on how to proceed thereafter.

 We propose to repeat a set of peripheral biopsies associated with transurethral resection of prostate to sample also a great amount of tissue of the inner-anterior zone of the gland. The resulting detection rate was really high: in a series of 14 patients who had at least 3 previous negative biopsies (the last one always performed in our center with an extented biopsy scheme) and a rising PSA, 8 were found to have prostate cancer.

 

Bibliographical reference:

Puppo P et al.: "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 Jan 18

 

Angelo Naselli

Urology Unit, Department of Surgical Oncology, National Institute for Cancer Research, Genoa, Italy