Korean J Urol.  2007 Oct;48(10):1010-1015. 10.4111/kju.2007.48.10.1010.

Role of Transurethral Resection of the Prostate in the Diagnosis of Prostate Cancer for Patients with Lower Urinary Tract Symptoms and Serum PSA 4-10ng/ml with a Negative Repeat Transrectal Needle Biopsy of Prostat

Affiliations
  • 1Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea. ushamd@catholic.ac.kr

Abstract

PURPOSE: Transrectal needle biopsy of the prostate is a definitive diagnostic procedure for prostate cancer. However, the sensitivity of a third biopsy is very low in patients with serum prostate-specific antigen(PSA) 4-10 ng/ml and negative repeat prostate biopsy. In addition, multiple prostate biopsies usually have low patient compliance due to the pain and complications associated with the procedure. The aim of this study was to evaluate the role of transurethral resection of the prostate(TURP) for the diagnosis of prostate cancer in patients with lower urinary tract symptoms and clinical suspicion but with negative repeat biopsy samples.
MATERIALS AND METHODS
From January 2000 to December 2006, 51 patients less than 80 years old underwent TURP at our institution for lower urinary tract symptoms with a serum PSA 4-10ng/ml and negative repeat transrectal needle biopsy of the prostate. We examined their first serum PSA, serum PSA before the TURP, PSA density, as well as their age, prostate size and digital rectal exam findings. The probability for the detection of prostate cancer by TURP was investigated retrospectively.
RESULTS
Prostate cancer was detected in seven patients(13.7%). The total Gleason score for the biopsy specimens was 5 in two patients, 6 in one patient and 7 in four patients. There were significant differences between the prostate cancer group and the benign prostate hypertrophy group with regard to the PSA density and prostate volume. However there were no significant differences between the first serum PSA and the serum PSA before TURP in the two groups.
CONCLUSIONS
In case with a high suspicion for prostate cancer, the TURP helps in the diagnosis of prostate cancer in those patients with a negative repeat biopsy and a serum PSA 4-10ng/ml and improvement of their lower urinary tract symptoms.

Keyword

Prostate cancer; Transurethral resection of prostate; Needle biopsy

MeSH Terms

Aged, 80 and over
Biopsy
Biopsy, Needle*
Diagnosis*
Humans
Hypertrophy
Lower Urinary Tract Symptoms*
Needles*
Neoplasm Grading
Patient Compliance
Prostate*
Prostatic Neoplasms*
Retrospective Studies
Transurethral Resection of Prostate
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