Repeat transrectal prostate biopsy in patients with high grade prostatic intraepithelial neoplasia: optimal time and technique

Abstract

Purpose. The aim of our study was to define optimal time and technique of repeat transrectal prostate biopsy in patients with high grade prostatic intraepithelial neoplasia.

Materials and Methods. A total of 277 men with high grade prostatic intraepithelial neoplasia regardless of changes in serum prostate specific antigen (PSA) or digital rectal examination findings underwent follow up biopsy in 8 months (range 1—12 months) after diagnosis. All men had at least 12 (12—18) biopsy cores taken at the time of diagnosis.

Results. Prostate cancer was found in 29,2% cases (81 of 277 patiens) after the second biopsy and in 2,9 % (1 of 35) cases after the third biopsy. The highest detection rate was found using 14 and 16 core biopsy schemes 12 and 6 months after the first biopsy.

Conclusions. Our findings support the concept that high grade prostatic intraepithelial neoplasia is a precursor to prostate cancer and that repeat biopsy at a delayed interval is recommended regardless of changes in PSA.