Strategy for repeat prostate biopsy: predictors of positive biopsy and additional biopsy location.
OBJECTIVE
We analyzed patterns of tumor distribution in radical prostatectomy specimens from patients with repeat biopsies to determine additional appropriate biopsy locations for repeat biopsy.


METHODS
Between January 2000 and June 2005, a total of 382 patients underwent transrectal ultrasound-guided prostate biopsy. Of these, 47 patients underwent repeat biopsy. Radical prostatectomy was performed for 7 of 22 cancer-positive cases. The 7 specimens were superimposed to create an idealized prostate gland at 3 levels: apex, mid-prostate, and base. We compared these tumor maps with those from 35 initial biopsy positive patients.


RESULTS
Prostate cancer was detected in 22 of 47 patients who underwent repeat biopsy. Tumor mapping showed that tumors detected on repeat biopsy in comparison with tumor maps of initial biopsy were dense at the periurethral area of the apex in prostate.


CONCLUSIONS
Additional biopsy cores taken from periurethral area of the apex on repeat biopsy might further enhance the detection of cancers.
Katto
Kazunobu
K
Department of Urology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
Takahashi
Masayuki
M
Taue
Ryuichi
R
Nakatsuji
Hiroyoshi
H
Kishimoto
Tomoteru
T
Izaki
Hirofumi
H
Oka
Natsuo
N
Fukumori
Tomoharu
T
Nishitani
Masa-Aki
MA
Kanayama
Hiro-Omi
HO