[Biopsy of the seminal vesicles in the staging of localized cancer of the prostate: technic and results].
OBJECTIVE
To allow the diagnosis of pathological stage C prostatic cancer before deciding on treatment.


METHODS
Seminal vesicle biopsy was performed as an outpatient procedure without anaesthesia. An identical antibiotic prophylaxis to that used for prostatic biopsy was performed. Biopsies were performed by longitudinal vision using a transrectal probe. A seminal vesicle needle biopsy was performed lateral to the prostate in the medial third of the seminal vesicle.


RESULTS
When seminal vesicle biopsies are positive, the final pathology report after radical prostatectomy confirmed the diagnosis in 100% of cases. When seminal vesicle biopsies were negative, seminal vesicle invasion was detected on the final pathology examination in one third of cases, mostly corresponding to exclusively intraprostatic involvement of the seminal vesicle. Biopsies are useful when at least one of the two prostatic bases is involved. In the series of the last 42 radical prostatectomies performed because of negative seminal vesicle biopsies, we detected only 11% of capsular lesions, almost always less than 1 mm, and 0% of ilio-obturator lymph node invasion.


CONCLUSIONS
Although the digital rectal examination findings, the PSA level, the Gleason score, and the number of positive biopsies and their length, allow an approach to preoperative staging, only seminal vesicle biopsies can provide a better preoperative staging of prostatic cancer for a given patient and no longer just statistically.
Vallancien
G
G
Département d'Urologie, Institut Montsouris, Paris, France.
Bochereau
G
G
Wetzel
O
O
Bretheau
D
D
Debras
B
B
Bougaran
Y
Y
Guillonneau
B
B
D000553:Ambulatory Care; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015365:Enoxacin / Q000627:therapeutic use; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010808:Physical Examination; D017430:Prostate-Specific Antigen / Q000032:analysis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012669:Seminal Vesicles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
D000890:Anti-Infective Agents; D015365:Enoxacin; D017430:Prostate-Specific Antigen