Objective: To compare ambulatory ultrasound-guided transrectal biopsy and finger-guided transperineal biopsy.
Material and methods: From June 1997 to October 1999, 51 patients were simultaneously biopsied by the two techniques and by the same operator, 30 min after antibiotic prophylaxis with 200 mg of Ciprofloxacin by intravenous injection. Transperineal biopsies were performed first, followed by ultrasound-guided transrectal biopsies. Six cores were obtained with each technique, from the apex, the middle and the base of each lobe.
Results: For a PSA level between 4 and 10 ng/ml, 6 cancers were detected in 23 patients (26%) and one cancer was only detected via the transrectal route. For a PSA level greater than 10 ng/ml, 17 cancers were detected in 28 patients (60%), 15 (53%) by transperineal biopsy and 11 (39%) by transrectal biopsy. Six cancers were only detected by transperineal biopsy and two were only detected by transrectal biopsy. No statistically significant difference was observed between the numbers of positive biopsies obtained with the two techniques.
Conclusion: The use of ultrasonography is not essential to perform systematic biopsies. Rather than the technique used, the detection of prostate cancer is improved by performing 12 cores instead of 6.