title: Is sampling transitional zone in patients who had prior negative prostate biopsy necessary?
abstract: OBJECTIVE
  To assess the necessity of transitional zone sampling of the prostate during repeat prostate biopsy procedures.
  
  
  METHODS
  Patients treated for lower urinary tract symptoms with transurethral resection of the prostate (TURP) from April 2004 to July 2009 whom had at least 1 negative prostate biopsy prior to this treatment were chosen as the study group. A histopathological analysis of surgical specimens was employed to determine cancer detection rates.
  
  
  RESULTS
  A total of 72 patients with the mean age of 66.1, mean prostate-specific antigen (PSA) of 10.4 ng/mL and mean prostate volume of 63.2 cc were included. Of the patients, 50 had 1 biopsy set, 17 had 2 sets, 4 had 3 sets and 1 patient had 4 sets of consecutive biopsies. All biopsy results were negative for prostate cancer. After the analysis of surgical specimens obtained during TURP, cancer was detected in 3 patients (4.2%). Transitional zone sampling during prostate biopsies did not significantly improve the cancer detection rate. Transitional zone sampling was performed in 29 biopsies taken from 20 patients, one of whom (5%) had prostate cancer. The remaining 71 biopsies were taken from 52 patients without transitional zone sampling, and cancer was detected in 2 (3.8%) of them.
  
  
  CONCLUSIONS
  Since no significant difference was observed between patient groups (those with and those without transitional zone biopsies) in the detection of prostate cancer in the transitional zone, strategies for increasing the number of cores taken from transitional zone during repeat biopsies should be reconsidered.
authors.affiliation: Department of 1st Urology, Ataturk Training & Research Hospital, Ankara, Turkey.
authors.forename: Bayram
authors.initials: B
authors.lastname: Dogan
authors.forename: Ege Can
authors.initials: EC
authors.lastname: Serefoglu
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Atmaca
authors.forename: Abdullah Erdem
authors.initials: AE
authors.lastname: Canda
authors.forename: Ziya
authors.initials: Z
authors.lastname: Akbulut
authors.forename: M
authors.initials: M
authors.lastname: Derya Balbay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011467:Prostate / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate
chemical_list: D017430:Prostate-Specific Antigen