We report a case of prenatally diagnosed congenital perineal mass which was combined with anorectal malformation. The mass was successfully treated with posterior sagittal anorectoplasty postnatally. On ultrasound examination at a gestational age of 23 weeks the fetal perineal mass were found on the right side. Any other defects were not visible on ultrasonography during whole gestation. Amniocentesis was performed to evaluate the fetal karyotyping and acetylcholinesterase which were also normal. As the fetus grew up, the mass size was slowly increased more and more. At birth, a female neonate had a perineal mass on the right side as expected. During operation, the anal sphincteric displacement was found near the mass and reconstructed through posterior sagittal incision. This is the first reported case of prenatally diagnosed congenital perineal mass, after birth which was diagnosed as lipoblastoma and even combined with anorectal malformation. This case shows that it can be of clinical importance to be aware of this rare fetal perineal mass in prenatal diagnosis and counseling.
Adult ; Amniocentesis ; *Anal Canal/abnormalities/pathology/ultrasonography ; *Digestive System Abnormalities/diagnosis/pathology/ultrasonography ; Female ; Gestational Age ; Humans ; Infant, Newborn ; *Lipoma/diagnosis/pathology/ultrasonography ; Male ; *Perineum/pathology/ultrasonography ; Pregnancy ; Prenatal Diagnosis ; *Rectal Neoplasms/diagnosis/pathology/ultrasonography ; *Rectum/abnormalities/pathology/ultrasonography ; Ultrasonography, Prenatal/*methods

OBJECTIVETo report our experience of ultrasound guided transperineal 6-core prostate biopsy (UG6CPB) in the diagnosis of prostate cancer (PCa).

METHODSIn a prospective study, we performed UG6CPB in 104 suspected PCa patients with tPSA more than 4 microg/L and analysed the positive rate and complications of the diagnostic approach.

RESULTSPCa was detected in 24 of the 104 patients (23%), with low grade Gleason 2 to 4 in 3 cases (12.5%), intermediate grade Gleason 5 to 7 in 15 (62.5%) and high grade Gleason 8 to 10 in the remaining 6 (25%). Complications included temporary hematuria in 5 patients (4.8%), mild postbiopsy perineal discomfort in 5 (4.8%) and fever in 4 (3.8%). TPSA > or =10 microg/L, fPSA > or = 2 microg/L, fPSA/tPSA < 0.16, PSAD > or = 0.2 and prostate volume < 40 ml were the significant influencing factors of biopsy positive rate (P < 0.05).

CONCLUSIONUG6CPB is an exact and a safe way of detecting PCa.

Biopsy, Needle ; methods ; Humans ; Male ; Perineum ; Prospective Studies ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo compare the detection rates of prostate cancer (PCa) and complications of the transrectal ultrasonography (TRUS)-guided 24-core saturation scheme versus 14-core scheme for transperineal prostate biopsy in patients with total PSA < 20 microg/L.

METHODSWe performed TRUS-guided 24-core saturation transperineal biopsy for 136 patients suspected of PCa (24-core group) and 14-core biopsy for another 116 (14-core group). We compared the PCa detection rates and post-biopsy complications, such as gross hematuria, urinary system infection, and acute urinary retention between the two groups.

RESULTSThe baseline characteristics of the two groups were comparable with regard to the mean age, prostate volume and PSA level (P>0.05). The positive rates of PCa detection were 48.53% (66/136) in the 24-core group and 17.24% (20/116) in the 14-core group (P<0.001), and the positive rates of samples were 8.09% and 2.83%, respectively (P=0.012). The detection rate of PCa in the apex zone was significantly higher in the former (11.76%) than in the latter (1.72%) (P<0.05). There were no statistically significant differences in such post-biopsy complications as gross hematuria, urinary system infection, and acute urinary retention between the two groups (P>0.05).

CONCLUSIONTRUS-guided 24-core saturation transperineal biopsy of the prostate is superior to the 14-core scheme for its higher detection rate of PCa, particularly PCa in the apex zone, and lower incidence of complications in patients with PSA < 20 microg/L.

Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Perineum ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo explore the clinical value and safety of TRUS-guided transperineal biopsy with the 9 + X method in the diagnosis of prostate carcinoma.

METHODSA total of 420 men underwent TRUS-guided transperineal biopsy with the 9 + X method for suspected prostate carcinoma. Their clinical data were retrospectively analyzed.

RESULTSProstate carcinoma was detected in 160 (38.1%) of the 420 cases, accounting for 7.4%, 17.8% and 65.4% in those with PSA < 4.0 microg/L, 4 -10 microg/L and > 10 microg/L respectively, 25.0% in those with abnormal findings on digital rectal examination (DRE), and 22.2% in those with abnormal echoes on TRUS or abdominal ultrasound examination. Complications after prostatic biopsy included gross hematuria in 79 cases (18.8%), acute urinary retention in 13 (3.1%) and fever in 9 (2.1%), but no other serious complications were observed.

CONCLUSIONTRUS-guided transperineal biopsy with the 9 + X method, with high accuracy and fewer complications, is an ideal approach to the diagnosis of prostate carcinoma.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Humans ; Male ; Middle Aged ; Perineum ; Prostate ; pathology ; Rectum ; diagnostic imaging ; Retrospective Studies ; Ultrasonography