The Role of TURP in the Detection of Prostate Cancer in BPH Patients with Previously Negative Prostate Biopsy.
10.4111/kju.2010.51.5.313
- Author:
Dae Keun KIM
1
;
Sang Jin KIM
;
Hong Sang MOON
;
Sung Yul PARK
;
Yong Tae KIM
;
Hong Yong CHOI
;
Tchun Yong LEE
;
Hae Young PARK
Author Information
1. Department of Urology, College of Medicine, Hanyang University, Seoul, Korea. haeypark@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Needle biopsy;
Prostatic neoplasms;
Transurethral resection of prostate
- MeSH:
Biopsy;
Biopsy, Needle;
Digital Rectal Examination;
Early Diagnosis;
Humans;
Lower Urinary Tract Symptoms;
Prostate;
Prostate-Specific Antigen;
Prostatic Hyperplasia;
Prostatic Neoplasms;
Retrospective Studies;
Transurethral Resection of Prostate;
Urinary Bladder Neck Obstruction
- From:Korean Journal of Urology
2010;51(5):313-317
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We aimed to investigate the significance of early detection of transition zone prostate cancer by transurethral resection of prostate (TURP) in benign prostatic hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS) in whom prostate cancer was suspected despite a negative transrectal ultrasonography (TRUS) biopsy result. MATERIALS AND METHODS: From January 2006 to January 2009, a total of 165 patients who underwent TURP were evaluated. The prostate cancer detection rate was compared between patients who underwent TRUS biopsy before TURP (group A) and those who did not (group B). All charts were evaluated retrospectively, including prostate-specific antigen (PSA), digital rectal examination (DRE), TURP results (including resection volume and pathology report), TRUS, and TRUS biopsy results. Group A was subdivided into group A1, who were diagnosed with prostate cancer after TURP, and group A2, who were diagnosed with BPH after TURP. RESULTS: The cancer detection rate showed no significant difference between groups A and B (8.9% vs. 7.5%, p>0.05). The mean PSA levels in groups A1 and A2 were 15.5+/-14.0 ng/ml and 9.1+/-5.1 ng/ml, respectively (p>0.05). In group A1, 40% had an abnormal DRE, compared with 6.7% in group A2 (p<0.05). After TURP, the mean percentage of resected prostatic chips of the prostate cancer group and BPH group were 33.9% and 18.6%, respectively (p=0.001). A positive correlation was found between the detection rate of prostate cancer and PSA (p=0.01). CONCLUSIONS: BPH patients in whom prostate cancer is suspected and who have lower urinary tract symptoms (LUTS) with a previously negative TRUS biopsy result can undergo TURP, which results in immediate improvement in bladder outlet obstruction and early diagnosis of clinically significant transition zone prostate cancer.
