Standardization of transrectal ultrasound-guided biopsy

Abstract

Ultrasound-guided biopsy is more sensitive to biopsy performed under the digital control, because 29% of prostatic cancers are not palpable. On the other hand, at least 30% of cancers are isoechogenic, so they cannot be viewed by transrectal ultrasound examination. It means that target biopsy is not sufficient for diagnosis of localized prostatic cancer, i.e., randomized samples are needed as well. More than ten years ago, the technique of sampling the six specimens became a standard procedure to which previously harvested target specimens from suspected growths were added. Today, the expansion of biopsy protocol is recommended, by obtaining the additional specimens from peripheral lateral area, four plus two samples if the prostate has volume over 50 ml. Larger number of biopsies requires anesthesia. In order to reduce complication, the cleaning of rectal ampulla and prophylactic use of quinolone are suggested.

Results of application of orthotopic urine diversion according to Studer

“…High degree of continence was also influenced by patient's age and absence of comorbidity. Increased number of radical retropubic prostatectomies performed in our institution over the last decade influenced improvement of the surgical technique enabling preservation of continence 10 .…”