Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

Radhakrishnan, S.; Dorkin, Trevor J.; Sheikh, N.; Greene, Damian

doi:10.1038/sj.pcan.4500756

Cited by 19 publications

(9 citation statements)

References 24 publications

(21 reference statements)

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“…23 However, a consistent number of PCa, not found by biopsy, are subsequently diagnosed by TURP or open adenomectomy. For this reason, after multiple negative biopsy series, some authors have suggested to perform a TURP, even in men not complaining LUTS: Radhakrishnan et al 24 Zigeuner et al 25 and Puppo et al 3 reported a PCa detection after TURP of 21, 7.9 and 42.8%, respectively. Recently, van Renterghem et al 26 in 82 patients with minor LUTS but elevated PSA levels evaluated the clinical benefits of TURP by assessing its effect on IPSS, PSA levels and cancer detection rate: they reported an incidental PCa in 9.8% of cases, whereas PSA levels and IPSS score in patients with BPH decreased to 1.1 and 1.5 ng ml À1 , respectively.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

Pepe

Fraggetta

Galia

et al. 2009

Prostate Cancer Prostatic Dis

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To evaluate prostate cancer (PCa) detection after repeated negative saturation biopsy, 75 patients, aged 53-78 years, underwent transurethral resection of prostate (TURP) because of persistent suspicion of cancer; median PSA was 11.8 ng ml À1 and 58 men complained lower urinary tract symptoms (LUTS). In 12 (16%) and 3 (4%) men a T1a and T1b PCa was found with median PSA and Gleason score equal to 14.2 vs 23.6 ng ml À1 and 5.6 vs 7 ng ml À1 . In case of persistent suspicion of PCa after repeated negative saturation biopsy, TURP may be proposed, aside from the coexistence of LUTS, to rule out a PCa, in younger patients with high PSA values (X20 ng ml À1 ).

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Section: Discussionmentioning

confidence: 99%

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

Pepe

Fraggetta

Galia

et al. 2009

Prostate Cancer Prostatic Dis

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“…However, the long-term follow-up of these patients remains unclear. Furthermore, the benefit of transition zone sampling by TURP in patients with rising PSA levels and multiple negative peripheral zone biopsies has been demonstrated [27] . In another study, it was concluded that BOO should not interfere when considering TURP as a treatment option [28] .…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcome of Diagnostic Transurethral Resection of the Prostate in Patients with Elevated Prostate-Specific Antigen Level and Minor Lower Urinary Tract Symptoms

Renterghem

Koeveringe²,

Achten³

et al. 2009

Urol Int

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Introduction: In patients with minor lower urinary tract symptoms (LUTS), elevated prostate-specific antigen (PSA) levels and (multiple) negative multi-site biopsies, therapy decision is complex. Long-term outcome of a diagnostic transurethral resection of the prostate (TURP) in these patients needs to be determined. Methods: We retrospectively evaluated patients with minor LUTS, elevated PSA levels (≥4 ng/ml) and no signs of prostate cancer. Patients with bladder outlet obstruction (BOO) underwent TURP. When TURP showed no malignancy, patients were annually evaluated by PSA testing and the International Prostate Symptom Score (IPSS). Results: The study included 82 consecutive patients satisfying the inclusion criteria. All patients underwent TURP. No malignancy was encountered in 74 patients (90.2%). Of this group, 36 patients were followed >3 years (mean 62.1 months). One patient (2.8%) showed a persistently rising PSA level with positive extended multi-site biopsies 4 years after TURP, implying further treatment. 35 patients (97.2%) had a permanent complete normalization of PSA levels (<4 ng/ml) together with normalized IPSS. Conclusions: We consider an elevated PSA level in patients with minor LUTS and (multiple) negative multi-site biopsies as a sign of BOO. If these patients receive a diagnostic TURP, long-term outcome is excellent.

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“…In the daily urological practice, we frequently meet patients with increased PSA levels and negative prostate biopsies [2]. In spite of re-biopsies, the histopathological findings still remain negative, and the patient presents bladder outlet obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of prostate cancer has increased with the use of prostate specific antigen (PSA) and the digital rectal examination as screening procedures for prostate cancer [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Role of transurethral resection of the prostate in the management of prostate cancer

Szöllősi

Martha

Dénes

et al. 2016

Acta Medica Marisiensis

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Introduction: Prostate cancer is the second most diagnosed cancer in men, after lung cancer. The gold standard procedure in prostate cancer (PCa) diagnosis is the ultrasound guided prostate biopsy. Transurethral resection of the prostate (TURP) used in solving the bladder outlet obstruction, can have a role in detection of PCa. The aim of this retrospective study is to examine the role of transurethral resection of the prostate in the diagnosis and therapy of prostate cancer. Materials and methods: At the Urology Clinic of Targu Mures we performed a total of 474 TURP over a two year period (2011)(2012)(2013). The patients had a mean age of 71.857 years, and the indications were PCa with bladder outlet obstruction or bladder outlet obstruction with unknown causes but some with suspicion of PCa. Results: In case of 474 patients with TURP performed for bladder outlet obstruction, the histopathology findings were the following: 61 cases with newly diagnosed PCa, some in spite of normal PSA values, 23 cases with already hormone treated prostate cancer, while in 50 cases TURP was preceded by prostate biopsy (in 8 cases with increased PSA and several negative biopsies, we could confirm PCa of the peripheral zone of the prostate). Conclusion: TURP remains the elective surgical therapy of the bladder outlet obstruction, caused by BPH and even prostate cancer. Obtaining a greater volume of prostate tissue can help in the detection of prostate cancer in its early stages, especially in the transitional zone.Keywords: prostate cancer, transurethral resection of the prostate, prostate specific antigen, bladder outlet obstruction, transrectal ultrasound guided prostate biopsy

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Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

Cited by 19 publications

References 24 publications

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

Long-Term Clinical Outcome of Diagnostic Transurethral Resection of the Prostate in Patients with Elevated Prostate-Specific Antigen Level and Minor Lower Urinary Tract Symptoms

Role of transurethral resection of the prostate in the management of prostate cancer

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