title: Transurethral resection biopsy as part of a saturation biopsy protocol: a cohort study and review of the literature.
abstract: OBJECTIVE
  To evaluate the prostate cancer (CaP) detection rate and morbidity of performing a transurethral resection biopsy of the prostate (TURBP) at the same time as a saturation biopsy (SBx).
  
  
  METHODS
  A total of 102 men with previous negative transrectal ultrasound (TRUS) biopsies underwent a SBx under formal anaesthesia. Fifty-four [54 (52.9%)] had a combined SBx and TURBP (Group 1) and 48 (47.1%) had a SBx only (Group 2).
  
  
  RESULTS
  The CaP detection rate in Group 1 was 38.9% (21/54), which was significantly higher than the detection rate of 27.1% (13/48) in Group 2 (P = 0.005). CaP was detected via TURBP in 12 patients (22.2%) from Group 1, including 8 (14.8%) patients who had CaP solely in their TURBP chips. According to the D'Amico classification, 66.6% (14/21) of the cancers in Group 1 were intermediate (n = 4) or high risk (n = 10). Of the 8 'TURBP only' cancers, 75% (6/8) were intermediate (n = 2) or high risk (n = 4). Seven of these eight patients went on to have a radical prostatectomy (RP) but only 2 (28.6%) were found to have a pure anterior/transition zone (TZ) tumor. The postoperative urinary retention and emergency admission rates for Groups 1 and 2 were 29.6% (16/54) vs. 16.6% (8/48) (P = 0.095) and 11.1% (6/54) vs. 5.5% (2/48) (n = 0.17). There was no difference in terms of hematuria (P = 0.54), urinary tract infection (UTI) (P = 0.22), or sepsis (P = 0.21), and patients in Group 1 spent an average of 0.5 days longer in hospital (1.9 vs. 1.4; P = 0.008).
  
  
  CONCLUSIONS
  TURBP in association with SBx increases the detection of clinically important CaP. However, this does have to be balanced against the small increased incidence of urinary retention, emergency re-admission, and longer hospital stay.
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorkshire, United Kingdom. d.yates@sheffield.ac.uk
authors.forename: David R
authors.initials: DR
authors.lastname: Yates
authors.forename: Gordon C
authors.initials: GC
authors.lastname: Gregory
authors.forename: Morgan
authors.initials: M
authors.lastname: Roupret
authors.forename: Manar M
authors.initials: MM
authors.lastname: Malki
authors.forename: Mark D
authors.initials: MD
authors.lastname: Haynes
authors.forename: Freddie C
authors.initials: FC
authors.lastname: Hamdy
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Rosario
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results; D012196:Review Literature as Topic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020728:Transurethral Resection of Prostate / Q000379:methods*