Current Trends in Biopsy Techniques

  • Joseph C. PrestiJr.
Part of the Current Clinical Urology book series (CCU)


Optimization of prostate cancer detection techniques is crucial for both medical and economic reasons. Early detection is more likely to result in curable disease. Opponents to prostate cancer screening often cite, as one of their arguments, the inefficiency of current detection strategies. Over the past several years, refinements in prostate cancer detection have focused on modifications in prostate-specific antigen (PSA; free:total ratios, complexed levels) as well as biopsy techniques. Transperineal biopsies performed under digital guidance were the predominant method of prostate cancer detection utilized until the 1980s. When introduced in 1989, systematic sextant biopsies under transrectal ultrasound guidance revolutionized our ability to detect prostate cancer (1). The pivotal work of Hodge et al. (1) resulted in a safe and rapid means to sample the prostate better. As originally described, systematic sextant biopsies are usually performed in the parasagittal plane halfway between the lateral border and midline of the prostate on both right and left sides from the base, mid-gland, and apex (Fig. 1). Derivation of the sextant template was random yet did provide a symmetric approach to sampling the prostate.


Prostate Biopsy Repeat Biopsy Cancer Detection Rate Biopsy Technique Sextant Biopsy 
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© Springer Science+Business Media New York 2004

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  • Joseph C. PrestiJr.

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