TRANSRECTAL BIOPSY OF THE PROSTATE GUIDED BY TRANSRECTAL ULTRASOUND IN AN ASEAN POPULATION:CORRELATION OF DIGITAL RECTAL EXAMINATION, PROSTATE SPECIFIC ANTIGEN LEVELS AND IMAGING WITH HISTOLOGY.
Keywords:
Transrectal ultrasound (TRUS), digital rectal examination (DRE), Prostatic Specific Antigen (PSA), prostatitis; glandular atypiaAbstract
Transrectal ultrasound (TRUS) followed, in the same sitting, by TRUS guided biopsy of the prostate was performed on 131 cases. Histological findings were prostatic carcinoma in 26 cases (19.8%), prostatitis in 11 cases (8.4%) and glandular atypia in 9 cases (6.9%).
The typical findings on digital rectal examination (DRE) were a hard, multinodular prostate for prostatic carcinoma and a hard, uninodular prostate for both prostatitis and glandular atypia. However its high false positive and false negative rates, 37.6% and 50% respectively, limits its role in predicting prostate pathology.
In terms of the Prostatic Specific Antigen (PSA), the mean levels for prostatic carcinoma, prostatitis and glandular atypia were 366, 17.5 and 7.2 ng/dl respectively.
On TRUS imaging, extracapsular and inhomogenicities in the peripheral zone (PZ) breach posted positive predictive values (PPV) of 100% and 71.4% for carcinoma respectively. Well defined solitary nodules were non specific and pointed move towards benign conditions such as prostatitis and atypia rather than carcinoma.
Patient acceptance of the procedure was high. Complications of the procedure were mild pain (23 cases), haematuria (12 cases), passing blood per rectum (4 cases) and fever (2 cases).
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