Retrospective review of prostate biopsies performed in Hospital La California, San José, Costa Rica from January 2018 until December 2019.
DOI:
https://doi.org/10.54212/27068048.v8i1.27Keywords:
Prostate cancer, prostate biopsy, twelve cylindersAbstract
Objectives: To evaluate the indications for trans rectal prostate biopsies and to correlate them with the eventual diagnosis for prostate cancer. To differentiate if digital rectal examination (DRE) or prostate specific antigen (PSA) have a greater positive predictive value. To determine if the current prostate biopsy protocol in our center is safe for our patients.
Materials and methods: A retrospective review of medical files of patients submitted for a trans rectal prostate biopsy at Hospital La California from January 2018 to December 2019. The samples were taken by Dr. Mario Gonzalez (urologist). A total of 200 biopsies were taken, only 168 patients that had complete information in their file such as PSA and DRE were included in the study. The indications for prostate biopsy were a PSA higher o equal to 2.5 ng/ml and any abnormal finding in the DRE suggesting prostatic malignancy. Complications such as bleeding requiring re admission prior to 12 hours after the biopsy and the appearance of fever above 38.5º C within the the first 24 hours after the biopsy were recorded.
Results and conclusions: From January 2018 until December 2019, 200 prostate biopsies were performed. 168 patients that met the criteria were included in the study. The mean age was 62.5 yrs (median 62 years). The average prostate size was 53.9 gramos. From the total of patients (n=168), 41 presented an abnormal DRE (24.4%). On the other hand, an abnormal PSA (0>2.5 ng/ml) was found in 162 cases (96.4%). Moreover, 22% (37/168) patients had both abnormal PSA and DRE.
Regarding clinical correlation with pathological findings, 35.1% of the cases resulted in adenocarcinoma of the prostate (59/168). In addition, abnormal DRE was associated with prostate cancer (CaP) in 18.4% (31/168) cases. When abnormal PSA and DRE were combined, 29/168 cases (17.2%) were positive.
There were no hospital re admissions (0/168) and only 4/168 presented a post biopsy prostatitis (0.02%), they were managed with intra muscular antibiotics and none required hospital admission.
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