title: Strategy for repeat prostate biopsy: predictors of positive biopsy and additional biopsy location.
abstract: 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.
authors.affiliation: Department of Urology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Katto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Taue
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakatsuji
authors.forename: Tomoteru
authors.initials: T
authors.lastname: Kishimoto
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Izaki
authors.forename: Natsuo
authors.initials: N
authors.lastname: Oka
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Fukumori
authors.forename: Masa-Aki
authors.initials: MA
authors.lastname: Nishitani
authors.forename: Hiro-Omi
authors.initials: HO
authors.lastname: Kanayama