title: Can we obtain better specimens with an end-cutting prostatic biopsy device?
abstract: OBJECTIVE
  Our aim was to compare the tissue yield of two different prostate biopsy instruments: the newer end-cut versus standard side-notch technique.
  
  
  METHODS
  A total of 87 patients, who underwent transrectal ultrasound guided prostate biopsy were included in the study between February 2003 and July 2003. Twenty-five patients underwent prostate biopsy with the end-cut technique with a stroke length of 33 mm (EC-33), 25 patients were biopsied with a stroke length of 23 mm of the same instrument (EC-23) whereas the remaining 37 patients underwent biopsy with an instrument working with side-notch technique with a 22 mm stroke length (SN). The length, weight and weight/length ratio (WLR) were measured for each biopsy core. The pathologic specimens were evaluated qualitatively. The length, weight and WLR as well as the complication rates, pain, zero biopsy rates, pathologic quality and cancer detection rates were compared between the groups.
  
  
  RESULTS
  Three groups were similar according to age, PSA values (free, total, free/total), prostate volumes (TZ, total) and PSA densities. The cancer detection rate was not statistically different between groups and was overall 20,9%. As the groups were compared according to mean core lengths, weights and densities the sequence was found to be EC-33>EC-23>SN. The EC group had higher prostatic glandular capture rates and better pathological quality. However, the zero biopsy rates were 12%, 7% and 1% for EC-33, EC-23 and SN groups, respectively and the difference was statistically significant. The complication rates after biopsy were similar for each group. The mean visual analogous scale scores were not significantly different between the groups. Another interesting finding was that cores containing cancer were heavier and denser than the others regardless of the instrument type.
  
  
  CONCLUSIONS
  The use of the presented new instrument, enables to obtain longer, heavier and denser cores with a higher pathologic quality and glandular coverage without increasing the number of biopsies and morbidity. However, the relatively high zero biopsy rate is a handicap that needs to be improved.
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, 06100, Sihhiye, Ankara, Turkey. hasedogan@yahoo.com
authors.forename: Hasan Serkan
authors.initials: HS
authors.lastname: Dogan
authors.forename: Saadettin Yilmaz
authors.initials: SY
authors.lastname: Eskicorapci
authors.forename: Dilek
authors.initials: D
authors.lastname: Ertoy-Baydar
authors.forename: Bulent
authors.initials: B
authors.lastname: Akdogan
authors.forename: Levent Mert
authors.initials: LM
authors.lastname: Gunay
authors.forename: Haluk
authors.initials: H
authors.lastname: Ozen
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012007:Rectum; D018084:Ultrasonography, Interventional / Q000379:methods