UICC World Cancer Congress 2006

Objective:To describe the diagnostic usefulness of digitally guided transrectal biopsy of the prostate. Methods: All men suspected of prostate cancer on the basis of abnormal digital rectal examination (DRE) and/or elevated prostate specific antigen (PSA) over a one-year period had transrectal prostate biopsy by a urologist using one finger in the rectum to guide the biopsy needle. This was an out-patient procedure using the Bard Monopty biopsy gun, with the patient lying on the left lateral position with the hips and knees flexed, without anesthesia or bowel preparation. Biopsy specimens were collected from the base, middle, and apex of each lateral lobe and reviewed by a pathologist. Patients received prophylactic antibiotics, and information about the process, benefits and risks of complication, and instructed to present if they developed severe pain, fever, haematuria or blood stained stools. They were scheduled for 2-week follow-up visit to review biopsy results. Results:44(84.6%) had abnormal DRE and elevated PSA, and 8(15.4%) had elevated PSA with normal DRE. PSA ranged from 1.8 – 228.5 ng/ml, mean 40.5ng/ml. All the patients tolerated the biopsy procedure well. Histopathological examination revealed carcinoma in 33(63.4%) men. Mean PSA was higher in patients with positive biopsy (48ngs/ml), compared to men with negative biopsy (21.4ng/ml). 6(11.5%) developed mild hematuria and/or blood stained stool, while 1(1.9%) patient with aplastic anemia presented with severe hematuria requiring admission and blood transfusion.