Objective: Valute 3 TRUS to study the transitional zone of the prostate to calculate the PSA density Tz in patient with first negative biopsy, PSA Tot > 4 ng/ml and clinical suspicion of cancer.
Methods: During a 12 months period we performed 429 biopsies. All patients had PSA = 4-10 ng/ml and/or suspected DRE. We repeated biopsy in 35 patients with PSA > 4 ng/ml, normal DRE but clinical suspicion of cancer. We used 3 TRUS to calculate the PSA density Tz and we performed standard sextant biopsies and additionally two biopsies of the transitional zone one on each side.
Results: Of the 429 patients, 304 (70.8%) had IPB, 100 (23.3%) had cancer in peripherical and/or apex zone, 25 (5.9%) cancer in the transitional zone only.
Conclusions: The use of 3 DUS is very important to study and estimate the volume of the transitional zone to calculate the PSA density Tz. The clear visualization of the Tz permit a careful execution of the biopsy. The biopsy of the TZ is not a method for the early detection to cancer prostate but only for specifics cases: negative first biopsy, negative DRE, PSA Tot > 4 ng/ml and clinical suspicion of cancer.
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