Ultrasound Guided Transrectal Core Biopsies of the Palpably Abnormal Prostate

No AccessJournal of Urology1 Jul 1989Ultrasound Guided Transrectal Core Biopsies of the Palpably Abnormal Prostate Kathryn K. Hodge, John E. McNeal, and Thomas A. Stamey Kathryn K. HodgeKathryn K. Hodge , John E. McNealJohn E. McNeal , and Thomas A. StameyThomas A. Stamey View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)38663-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Ultrasound imaging and ultrasound guided transrectal core biopsies were performed in 251 consecutive men with abnormal prostates on digital rectal examination. A hypoechoic defect on ultrasound was identified in 227 of 251 patients (90 per cent) corresponding to the area of palpable nodularity or abnormal firmness. A mean of 6.25 biopsies were obtained per patient using a commercially available spring-loaded gun. Biopsies were positive for cancer in 165 of the 251 prostates (66 per cent). Palpable nodules more often were hypoechoic and more often contained cancer than less distinct areas of abnormal firmness on digital examination. Among the clinical stages Bl, B2 and B3 nodules 70, 76 and 88 per cent, respectively, were positive for cancer, as were 100 per cent of the clinical stage C prostates. Of 77 abnormally firm, nonnodular prostates 36 per cent were positive for cancer. Random biopsy of the contralateral normal lobe in 56 men with clinical stage Bl or B2 nodules showed cancer present contralaterally in 42 and 60 per cent, respectively; 20 per cent had positive biopsies despite a contralateral isoechoic ultrasound. In 78 patients with prior digitally guided biopsies, ultrasound guided biopsies confirmed previously diagnosed cancers in 94 per cent. However, in 23 of 43 patients (53 per cent) with previous negative digitally guided biopsies, ultrasound guided biopsies made the new diagnosis of cancer. Complications, including post-biopsy fever and bleeding, occurred in 6 of 251 patients (2.4 per cent). The combination of the new spring-loaded biopsy guns and transrectal ultrasound guidance of biopsies provides the urologist with a tool that allows multiple prostate cores to be obtained safely and painlessly, reducing the sampling error and increasing the accuracy in diagnosing prostate cancer in the man with a palpable abnormality of the prostate. © 1989 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByNam R, Saskin R, Lee Y, Liu Y, Law C, Klotz L, Loblaw D, Trachtenberg J, Stanimirovic A, Simor A, Seth A, Urbach D and Narod S (2018) Increasing Hospital Admission Rates for Urological Complications After Transrectal Ultrasound Guided Prostate BiopsyJournal of Urology, VOL. 189, NO. 1S, (S12-S18), Online publication date: 1-Jan-2013.Qi C, Malczynski M, Schaeffer A, Barajas G, Nadler R, Scheetz M and Zembower T (2018) Characterization of Ciprofloxacin Resistant Escherichia coli Isolates among Men Undergoing Evaluation for Transrectal Ultrasound Guided Prostate BiopsyJournal of Urology, VOL. 190, NO. 6, (2026-2032), Online publication date: 1-Dec-2013.Taylor A, Zembower T, Nadler R, Scheetz M, Cashy J, Bowen D, Murphy A, Dielubanza E and Schaeffer A (2018) Targeted Antimicrobial Prophylaxis Using Rectal Swab Cultures in Men Undergoing Transrectal Ultrasound Guided Prostate Biopsy is Associated With Reduced Incidence of Postoperative Infectious Complications and Cost of CareJournal of Urology, VOL. 187, NO. 4, (1275-1279), Online publication date: 1-Apr-2012.Liss M, Chang A, Santos R, Nakama-Peeples A, Peterson E, Osann K, Billimek J, Szabo R and Dash A (2018) Prevalence and Significance of Fluoroquinolone Resistant Escherichia coli in Patients Undergoing Transrectal Ultrasound Guided Prostate Needle BiopsyJournal of Urology, VOL. 185, NO. 4, (1283-1288), Online publication date: 1-Apr-2011.Nam R, Saskin R, Lee Y, Liu Y, Law C, Klotz L, Loblaw D, Trachtenberg J, Stanimirovic A, Simor A, Seth A, Urbach D and Narod S (2018) Increasing Hospital Admission Rates for Urological Complications After Transrectal Ultrasound Guided Prostate BiopsyJournal of Urology, VOL. 183, NO. 3, (963-969), Online publication date: 1-Mar-2010.Klein T, Palisaar R, Holz A, Brock M, Noldus J and Hinkel A (2018) The Impact of Prostate Biopsy and Periprostatic Nerve Block on Erectile and Voiding Function: A Prospective StudyJournal of Urology, VOL. 184, NO. 4, (1447-1452), Online publication date: 1-Oct-2010.Baden J, Green G, Painter J, Curtin K, Markiewicz J, Jones J, Astacio T, Canning S, Quijano J, Guinto W, Leibovich B, Nelson J, Vargo J, Wang Y and Wuxiong C (2018) Multicenter Evaluation of an Investigational Prostate Cancer Methylation AssayJournal of Urology, VOL. 182, NO. 3, (1186-1193), Online publication date: 1-Sep-2009.Cooner W, Mosley B, Rutherford C, Beard J, Pond H, Terry W, Igel T and Kidd D (2018) Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigenJournal of Urology, VOL. 167, NO. 2 Part 2, (966-974), Online publication date: 1-Feb-2002.Carey J and Korman H (2018) Re: Transrectal Ultrasound Guided Biopsy of the Prostate. Do Enemas Decrease Clinically Significant Complications?Journal of Urology, VOL. 167, NO. 5, (2146-2146), Online publication date: 1-May-2002.DJAVAN B, WALDERT M, ZLOTTA A, DOBRONSKI P, SEITZ C, REMZI M, BORKOWSKI A, SCHULMAN C and MARBERGER M (2018) SAFETY AND MORBIDITY OF FIRST AND REPEAT TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSIES: RESULTS OF A PROSPECTIVE EUROPEAN PROSTATE CANCER DETECTION STUDYJournal of Urology, VOL. 166, NO. 3, (856-860), Online publication date: 1-Sep-2001.CAREY J and KORMAN H (2018) TRANSRECTAL ULTRASOUND GUIDED BIOPSY OF THE PROSTATE. DO ENEMAS DECREASE CLINICALLY SIGNIFICANT COMPLICATIONS?Journal of Urology, VOL. 166, NO. 1, (82-85), Online publication date: 1-Jul-2001.RODRIGUEZ L and TERRIS M (2018) RISKS AND COMPLICATIONS OF TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSY: A PROSPECTIVE STUDY AND REVIEW OF THE LITERATUREJournal of Urology, VOL. 160, NO. 6 Part 1, (2115-2120), Online publication date: 1-Dec-1998.VASHI A, WOJNO K, GILLESPIE B and OESTERLING J (2018) A MODEL FOR THE NUMBER OF CORES PER PROSTATE BIOPSY BASED ON PATIENT AGE AND PROSTATE GLAND VOLUMEJournal of Urology, VOL. 159, NO. 3, (920-924), Online publication date: 1-Mar-1998.Levine M, Ittman M, Melamed J and Lepor H (2018) TWO CONSECUTIVE SETS OF TRANSRECTAL ULTRASOUND GUIDED SEXTANT BIOPSIES OF THE PROSTATE FOR THE DETECTION OF PROSTATE CANCERJournal of Urology, VOL. 159, NO. 2, (471-476), Online publication date: 1-Feb-1998.Sieber P, Rommel F, Agusta V, Breslin J, Huffnagle H and Harpster L (2018) Antibiotic Prophylaxis in Ultrasound Guided Transrectal Prostate BiopsyJournal of Urology, VOL. 157, NO. 6, (2199-2200), Online publication date: 1-Jun-1997.Terris M, Macy M and Freiha F (2018) Transrectal Ultrasound Appearance of Prostatic Granulomas Secondary to Bacillus Calmette-Guerin InstillationJournal of Urology, VOL. 158, NO. 1, (126-127), Online publication date: 1-Jul-1997.Huland H, Hammerer P, Henke R and Huland E (2018) Preoperative Prediction of Tumor Heterogeneity and Recurrence After Radical Prostatectomy for Localized Prostatic Carcinoma with Digital Rectal Examination, Prostate Specific Antigen and the Results of 6 Systematic BiopsiesJournal of Urology, VOL. 155, NO. 4, (1344-1347), Online publication date: 1-Apr-1996.Desmond P, Clark J, Thompson I, Zeidman E and Mueller E (2018) Morbidity with Contemporary Prostate BiopsyJournal of Urology, VOL. 150, NO. 5 Part 1, (1425-1426), Online publication date: 1-Nov-1993.Ackerman D, Barry J, Wicklund R, Olson N and Lowe B (2018) Analysis of Risk Factors Associated with Prostate Cancer Extension to the Surgical Margin and Pelvic Node Metastasis at Radical ProstatectomyJournal of Urology, VOL. 150, NO. 6, (1845-1850), Online publication date: 1-Dec-1993.Keizur J, Lavin B and Leidich R (2018) Iatrogenic Urinary Tract Infection with Pseudomonas Cepacia after Transrectal Ultrasound Guided Needle Biopsy of the ProstateJournal of Urology, VOL. 149, NO. 3, (523-526), Online publication date: 1-Mar-1993.Mcwhorter W, Hernandez A, Meikle A, Terreros D, Smith J, Skolnick M, Cannon-Albright L and Eyre H (2018) A Screening Study of Prostate Cancer in High Risk FamiliesJournal of Urology, VOL. 148, NO. 3 Part 1, (826-827), Online publication date: 1-Sep-1992.Terris M, McNeal J and Stamey T (2018) Detection of Clinically Significant Prostate Cancer by Transrectal Ultrasound-Guided Systematic BiopsiesJournal of Urology, VOL. 148, NO. 3 Part 1, (829-832), Online publication date: 1-Sep-1992.Teichman J, Tsang T and McCarthy M (2018) Osteitis Pubis as a Complication of Transrectal Needle Biopsy of the ProstateJournal of Urology, VOL. 148, NO. 4, (1260-1261), Online publication date: 1-Oct-1992.Lippman H, Ghiatas A and Sarosdy M (2018) Systematic Transrectal Ultrasound Guided Prostate Biopsy After Negative Digitally Directed Prostate BiopsyJournal of Urology, VOL. 147, NO. 3 Part 2, (827-829), Online publication date: 1-Mar-1992.Stamey T (2018) Diagnosis of Prostate Cancer: A Personal ViewJournal of Urology, VOL. 147, NO. 3 Part 2, (830-832), Online publication date: 1-Mar-1992.Hammerer P, Loy V, Dieringer J and Huland H (2018) Prostate Cancer in Nonurological Patients with Normal Prostates on Digital Rectal ExaminationJournal of Urology, VOL. 147, NO. 3 Part 2, (833-836), Online publication date: 1-Mar-1992.Daniels G, Mcneal J and Stamey T (2018) Predictive Value of Contralateral Biopsies in Unilaterally Palpable Prostate CancerJournal of Urology, VOL. 147, NO. 3 Part 2, (870-874), Online publication date: 1-Mar-1992.Coplen D, Andrile G, Yuan J and Catalona W (2018) The Ability of Systematic Transrectal Ultrasound Guided Biopsy to Detect Prostate Cancer in Men with the Clinical Diagnosis of Benign Prostatic HyperplasiaJournal of Urology, VOL. 146, NO. 1, (75-77), Online publication date: 1-Jul-1991.Terris M, Freiha F, McNeal J and Stamey T (2018) Efficacy of Transrectal Ultrasound for Identification of Clinically Undetected Prostate CancerJournal of Urology, VOL. 146, NO. 1, (78-84), Online publication date: 1-Jul-1991.Sohlberg O, Chetner M, Ploch N and Brawer M (2018) Prostatic Abscess After Transrectal Ultrasound Guided BiopsyJournal of Urology, VOL. 146, NO. 2 Part 1, (420-422), Online publication date: 1-Aug-1991.Vallancien G, Prapotnich D, Veillon B, Brisset J and Andre-Bougaran J (2018) Systematic Prostatic Biopsies in 100 Men with No Suspicion of Cancer on Digital Rectal ExaminationJournal of Urology, VOL. 146, NO. 5, (1308-1312), Online publication date: 1-Nov-1991.Palken M, Cobb O, Simons C, Warren B and Aldape H (2018) Prostate Cancer: Comparison of Digital Rectal Examination and Transrectal Ultrasound for ScreeningJournal of Urology, VOL. 145, NO. 1, (86-90), Online publication date: 1-Jan-1991.Chodak G (2018) Editorial CommentsJournal of Urology, VOL. 145, NO. 1, (90-91), Online publication date: 1-Jan-1991.Terris M, Villers A and Freiha F (2018) Transrectal Ultrasound Appearance of Transitional Cell Carcinoma Involving the ProstateJournal of Urology, VOL. 143, NO. 5, (953-956), Online publication date: 1-May-1990.Cooner W, Mosley B, Rutherford C, Beard J, Pond H, Terry W, Igel T and Kidd D (2018) Prostate Cancer Detection in a Clinical Urological Practice by Ultrasonography, Digital Rectal Examination and Prostate Specific AntigenJournal of Urology, VOL. 143, NO. 6, (1146-1152), Online publication date: 1-Jun-1990.Hodge K, McNeal J, Terris M and Stamey T (2018) Random Systematic Versus Directed Ultrasound Guided Transrectal Core Biopsies of the ProstateJournal of Urology, VOL. 142, NO. 1, (71-74), Online publication date: 1-Jul-1989.Paulson D (2018) Editorial CommentsJournal of Urology, VOL. 142, NO. 1, (74-74), Online publication date: 1-Jul-1989.Kabalin J, Hodge K, McNeal J, Freiha F and Stamey T (2018) Identification of Residual Cancer in the Prostate Following Radiation Therapy: Role of Transrectal Ultrasound Guided Biopsy and Prostate Specific AntigenJournal of Urology, VOL. 142, NO. 2 Part 1, (326-331), Online publication date: 1-Aug-1989.Resnick M (2018) Editorial CommentsJournal of Urology, VOL. 142, NO. 1, (74-75), Online publication date: 1-Jul-1989. Volume 142Issue 1July 1989Page: 66-70 Advertisement Copyright & Permissions© 1989 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Kathryn K. Hodge More articles by this author John E. McNeal More articles by this author Thomas A. Stamey More articles by this author Expand All Advertisement PDF DownloadLoading ...