Ultrasonographically Guided Transperineal Prostate Biopsy in Patients with Suspicious Glands and Previously Negative Digitally Guided Biopsies

Transrectal longitudinal linear-array ultrasonography was used to guide transperineal needle biopsy of the prostate in 16 patients with suspicious digital rectal findings. All the patients had undergone digitally guided transrectal biopsy of the prostate within the previous 6 months that had shown no malignancy, and all of the patients had hypoechoic areas in the posterolateral aspects of the prostate. In addition, other echo patterns and calcifications were noted. The suspicious areas in the prostate gland were clearly visible, and the needle was easily guided to the lesions after local anesthesia was given. At least two cores were obtained with a 14-gauge Tru-Cut needle. The ultrasonographically guided biopsies revealed adenocarcinoma of the prostate in 6 of the 16 patients. No complications were encountered. Our data suggest that in patients with a palpably suspicious prostate and a negative digitally guided biopsy, repeated biopsy with ultrasonographic guidance is indicated and will have a substantial positive yield.