Is ultrasound guidance necessary for transrectal prostate biopsy?
OBJECTIVE
The relatively simultaneous development of spring-loaded biopsy devices and the proliferation of transrectal ultrasonography for transrectal guidance of biopsy needles have led to the general use of both technologies for transrectal prostate biopsy. This review was done because the incremental cost of ultrasonographic guidance is considerable and the marginal improvement of sensitivity over digital guidance alone is unknown.


METHODS
A total of 200 consecutive men underwent prostate biopsy with digital and ultrasound guidance.


RESULTS
Biopsy sensitivity was superior for ultrasound guidance in all categories of tumors studied, with an overall sensitivity of 88% compared to 74% for digital guidance. Nevertheless, 12% of the tumors were detected with digital rectal examination guidance alone.


CONCLUSIONS
These data suggest that the optimal method of prostate biopsy may include ultrasound and digital guidance.
Renfer
L G
LG
Urological Surgery Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
Schow
D
D
Thompson
I M
IM
Optenberg
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity; D014463:Ultrasonography