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Analiză comparativă retrospectivă a protocolului extins versus protocolul de saturaţie la al doilea set de biopsii prostatice.

Source: Romanian Journal of Urology. Dec, Vol. Author s : Sinescu, I. Abstract: Introduction and Objectives: Increasing of specific prostatic antigen and a suspicious rectal examination are the main causes to perform prostatic biopsy.

After a first prostatic biopsy with negative result, some patients have high risk of having cancer and therefore is indicated to repeat biopsy. There is much debate on the subject of how many cores should be cu prostatita, doare stomacul after a first negative biopsy results. Extended and saturation biopsy protocols are the most frequent used procedures for second biopsy set.

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The aim of this study is to compare the cancer detection, pain level, and complications after extended versus saturation biopsy protocols. Material and methods: patients for whom a second set of prostate biopsy was performed between and were analyzed retrospectively. Out of patients, an extended protocol was used for 66 patients and a saturation protocol for 42 patients.

The indications for the second set of biopsies were suspicious rectal examination for 12 patients, persistent high tPSA for 73 patients, atipia psa test prostate cancer biopsy 8 patients and high-grade PIN for 15 patients.

Extended biopsy protocol included 12 cores from peripheral zone and saturation protocol included 26 - 28 cores from peripheral zone and transitional zone. All biopsy was performed by the same urologist and all specimens were analyzed in our center by the same pathologist.

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The pain level during biopsy was determined using a visual analog scale graded from 0 to We recorded both minor haematuria, haematospermia, urethroragy, rectal bleeding, acute urinary retention and major fever, septic shock complications after this procedure.

Results: The mean age of the patients was Detection of prostate cancer using extended and saturation biopsy technique was The mean visual analog scale pain psa test prostate cancer biopsy was 2. There were no differences in minor and major complications between two groups except the urethroragy.

None of these patients required hospitalization for any complication after prostatic biopsy. Conclusion: The prostate cancer detection rate after saturation biopsy was better then after extended biopsy protocol with no significant increasing of morbidity. Additionally, it was no significant difference in the level of the pain during these procedures. The low rate of complications after saturation biopsy recommends this technique to be safely performed after the first negative biopsy.

We believe that the saturation biopsy protocol can be performed in the outpatient department with periprostatic nerve block anesthesia, avoiding the potential risks of intravenous anesthesia. Copyright of Romanian Journal of Urology is the property of Romanian Journal of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission.

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