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Prostate Cancer

Prostate Biopsy Methods and Accuracy

05/20/2008

Question:

My urologist attempted to perform a transrectal type biopsy recently, but was unable to complete the procedure due to a narrowing of the recturm/anus as a consequence of hemorrhoid surgery some 35 years ago. I am aware of two other biopsy methods [perineal and transureathral], but does anyone perform that method and if so would it be reliable? Does anyone have any suggestions?

Answer:

Transperineal prostate biopsy was routine in the past, before the advent of ultrasound guidance. The transperineal approach typically required anesthesia and, lacking the ultrasound guidance, frequently the tissue biopsied was tissue outside the prostate.

Since the perineal biopsy would require anesthesia, I would recommend transrectal US (ultrasound) guided prostate biopsy to decrease the discomfort, but obtain an accurate biopsy.

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Response by:

James F Donovan, Jr, MD James F Donovan, Jr, MD
Professor of Surgery
Director of UC Urology
College of Medicine
University of Cincinnati