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Optimum Prostate Biopsy: Techniques and Strategies

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Management of Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Since its dissemination 20 years ago, prostate-specific antigen (PSA) has revolutionized the landscape of prostate cancer (PCa) detection and resulted in a considerable stage migration. Such results would not have been achieved without the contemporary refinements of the technique of prostate biopsy (PBx). PBx has evolved from the digitally guided transrectal biopsy, described by Astraldi in 1937, to the systematic biopsy method, described by Hodge et al. in 1989. Over the past few years, there has been a rising interest in defining more accurate PBx schemes in an attempt to improve PCa detection. Intuitively, this aim could be mainly achieved by adding more biopsies to prostatic areas not sampled by standard sextant schemes as initially described by Hodge. The introduction of effective local anesthesia periprostatic block has allowed an increase in the number of biopsies taken in the outpatient setting without increasing discomfort and pain. Thus, the concepts of “extended biopsy (ePBx)” and “saturation biopsy (sPBx)” have rapidly evolved in the past 10 years, radically changing the general idea of PBx. Moreover, modern efforts have been focused on the use of new imaging modalities and configuration of the biopsy probe in attempts to further enhance PCa detection.

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  1. Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue/Q10-1, Cleveland, OH, 44195, USA

    Osama M. Zaytoun & J. Stephen Jones

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  1. , Glickman Urological and Kidney, Cleveland Clinic, 9500 Euclid Ave, Cleveland, 44195, Ohio, USA

    Eric A. Klein

  2. Cleveland Clinic, Cleveland Clinic Lerner College of Medic, Department of Regional Urology, at Case Western Reserve, Cleveland, 44195, Ohio, USA

    J. Stephen Jones

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Zaytoun, O.M., Jones, J.S. (2012). Optimum Prostate Biopsy: Techniques and Strategies. In: Klein, E., Jones, J. (eds) Management of Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-259-9_11

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