Yonsei Med J.  2013 Jan;54(1):81-86. 10.3349/ymj.2013.54.1.81.

Effects of Post Biopsy Digital Rectal Compression on Improving Prostate Cancer Staging Using Magnetic Resonance Imaging in Localized Prostate Cancer

• Park KK
• Chung MS
• Chung SY
• Kim JH
• Chung BH

• KMID: 1776921
• DOI: http://doi.org/10.3349/ymj.2013.54.1.81

Abstract

PURPOSE
To evaluate the effectiveness of digital rectal-compression immediately after transrectal prostate biopsy (P-bx) for improving the accuracy of prostate cancer (PCa) staging.
MATERIALS AND METHODS
Between July 2008 and June 2010, 94 consecutive patients who had a radical prostatectomy were included in our retrospective analysis. The exclusion criteria included a history of previous P-bx and surgery, a biopsy performed in another hospital, a number of biopsy cores different from 12, or a condition interfering with bleeding assessment. The subjects were divided into two groups, compression and non-compression. All enrolled patients took magnetic resonance imaging (MRI) for PCa staging.
RESULTS
The compression and non-compression groups were comparable with respect to several baseline characteristics. However, the total hemorrhage score of intraprostatic bleeding was significantly different between the groups, even with adjustment for the time from biopsy to MRI (compression:15.4+/-2.32, non-compression: 24.9+/-2.43, p<0.001). The intra-prostatic cancer location matching rate was higher in the compression group (78.0%) than in the non-compression group (70.2%) (p=0.011). Overall accuracy of staging in compression and non-compression groups was 84.7% and 77.3%, respectively.
CONCLUSION
Our results demonstrate that digital rectal compression performed immediately after prostate biopsy to reduce intraprostatic hemorrhage improves the accuracy for detection of PCa using MRI.

Keyword

Needle biopsy; prostate neoplasm; magnetic resonance imaging; hemorrhage; hemostatic technique

MeSH Terms

Aged
*Biopsy
Biopsy, Needle
*Digital Rectal Examination
Hemorrhage/prevention & control
Hemostasis
Humans
*Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging/*methods
Pressure
Prostate/pathology
Prostatic Neoplasms/*diagnosis/*pathology
Reproducibility of Results
Retrospective Studies

Figure

• 

  Fig. 1 Prostate cancer matching rate for compression and non-compression groups according to the time between biopsy and MRI. Control: non-compression group, *p=<0.05, (p value: 0.023 in 1 week, 0.044 in 2 week, 0.039 in 3 week, 0.031 in 4 week). MRI, magnetic resonance imaging.

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