Diagnostic value of ten systematic TRUS-guided prostate biopsies

Objective: To evaluate the improvement in the rate of detection of prostate cancer using an extensive protocol involving ten transrectal biopsies. Methods: A total of 162 patients submitted to transrectal ultrasound-guided biopsy for elevated prostate-specific antigen (PSA) and/ or abnormality on digital rectal examination were studied consecutively and prospectively, Five biopsies were performed in each lobe: between the three standard biopsies on each side, two additional biopsy specimens were taken in the same plane and at the same 45 degrees angle. Results: The complication rate with the ten-biopsy protocol was 1.85%, Prostate cancer was detected in 40.1% of the patients. In the overall series, the percentage of diagnostic improvement brought about by this ten-biopsy protocol was +3.1%, The percentage improvement was greatest (+4.9%) in patients with PSA less than or equal to 10 ng/ml, Conclusion: Increasing the number of biopsy cores without altering the angle of biopsy and/or the zone sampled does not lead to a significant improvement in the detection of prostate cancer.