TRANSRECTAL ULTRASOUND-GUIDED MAPPING BIO PSY OF THE PROSTATE - CORRELATION TO PATHOHISTOLOGICAL FINDINGS AND MORBIDITY

The detection rate of adenocarcinoma of the prostate has been signific antly increased through introduction of systematic transrectal ultraso und-guided ''mapping'' biopsies of the prostate. In a study of 51 pati ents, we investigated the histological results of this preoperatively feasible method and compared these with tumor spread and margin positi vity in the histological specimen obtained from radical prostatectomy. In a separate study we investigated the morbidity and patient accepta nce of the transrectal ultrasound-guided ''mapping'' biopsy in 76 pati ents. A significant difference between the number of positive biopsies in correlation to the pT-stage was found (pT2: 1.64+/-1.0 versus pT3: 3.08+/-1.6, p < 0.01). Furthermore, a difference between the number o f positive biopsies in correlation to positive and negative surgical m argins, was seen (3,75 +/- 1,85 vs 1,74 +/- 1,01, p < 0,001). Concerni ng the prediction of tumor spread in both lobes of the prostate gland, a notable ''understaging'' by ''mapping'' biopsies was found. Morbidi ty after ''mapping'' biopsy was acceptable. Besides improvement in det ection rate, the ''mapping'' biopsy can render important information a bout tumor extent and the chance of positive surgical margins after ra dical prostatectomy.