title: A prospective randomized comparison of extensive prostate biopsy to standard biopsy with assessment of diagnostic yield, biopsy pain and morbidity.
abstract: In a prospective randomized study, we compare standard prostate biopsy to extensive biopsy utilizing intravenous conscious sedation (IVCS). Initial biopsy patients (n=197) were randomized to either standard biopsy using intrarectal lidocaine gel (6-12 biopsies, mean 10.1) or extensive biopsy (24 biopsies) using IVCS. Cancer detection and urinary symptoms were no different between groups. However, biopsy pain was rated significantly lower and satisfaction significantly higher in the extensive biopsy group. Temporary urinary retention occurred in 4% of the extensive biopsy group. Extended biopsy with 24 samples does not improve cancer detection compared to standard biopsy when 10 cores are obtained. Extensive biopsy is very well tolerated and associated with less pain and more satisfaction than standard biopsy.
authors.affiliation: Department of Urology, Naval Medical Center, San Diego, California 92134-5000, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Sur
authors.forename: P G
authors.initials: PG
authors.lastname: Borboroglu
authors.forename: J L
authors.initials: JL
authors.lastname: Roberts
authors.forename: C L
authors.initials: CL
authors.lastname: Amling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods*; D016292:Procedural Sedation; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D009017:Morbidity; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D005283:Fentanyl