[Importance of transrectal ultrasonography in the detection of local recurrence of prostatic carcinoma after radical prostatectomy].
OBJECTIVE
To assess the importance of transrectal ultrasonography in early detection of local recurrence of prostate carcinoma in patients after radical retropubic prostatectomy and compare it with digital rectal examination and the level of prostatic specific antigen.


METHODS
In a group of 72 patients, at least six months after radical prostatectomy regularly after 3-6-month intervals the levels of prostatic specific antigen were monitored. When the level of specific prostatic antigen was repeatedly higher than 0.2 ng/ml or when it increased as compared with the previous examination the patient was submitted to digital rectal examination and transrectal ultrasonography of the bed after radical prostatectomy. In case of a positive sonographic finding, ultrasound-guided biopsy was performed.


RESULTS
A local recurrence of the disease was confirmed by ultrasound-guided biopsy in 5 (6.9%) of 72 investigated patients on average 51 months (23-81) after radical prostatectomy. The mean preoperative value of the prostatic specific antigen was in these patients 23.4 ng/ml (10.6-33). In all patients the authors detected by transrectal ultrasonography a hypoechoic focus at the site of anastomosis. Of 5 patients with a local recurrence of the disease two (40%) had a negative digital rectal examination.


CONCLUSIONS
The prostatic specific antigen monitored most accurately the local progression of the disease after radical prostatectomy. Transrectal ultrasonography detected a local recurrence of the disease in all five patients despite the negative digital rectal examination. Transrectal ultrasonography makes guided biopsy from the site of radical prostatectomy possible and thus increases the detection rate of local progress of the disease as compared with digital rectal examination. Elevation of the prostatic specific antigen with subsequent transrectal ultrasonographic examination makes it possible to detect as soon as possible early local recurrence of prostate carcinoma after radical prostatectomy.
L'upták
J
J
Urologická klinika JLF UKo a MFN, Martin, Slovenská republika.
Kliment
J
J
Svihra
J
J
Eliás
B
B
D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D014463:Ultrasonography