RADICAL PROSTATECTOMY - TRANSRECTAL SONOGRAPHIC EVALUATION TO ASSESS FOR LOCAL RECURRENCE

PURPOSE: To determine sonographic features associated with locally rec urrent or residual tumor. MATERIALS AND METHODS: Twenty-three transrec tal ultrasound (TRUS) studies were performed in 21 patients with suspe cted recurrent prostatic carcinoma after prostatectomy. The original p rospective TRUS reports were reviewed, followed by blinded review, and the findings were compared with biopsy results. RESULTS: A discrete p erianastomotic mass was identified prospectively in eight (73%) of 11 patients with positive biopsy results and in two (17%) of 12 with nega tive results; no mass was identified in the remaining patients. At pre liminary retrospective review, the echogenic retroanastomotic fat plan e was not intact in 10 (91%) of 11 patients with positive biopsy resul ts and in two (17%) of 12 with negative results; it was intact in the remaining patients. CONCLUSION: Sonographic visualization of a mass in the prostate bed or loss of integrity of the retroanastomotic fat pla ne is strongly correlated with finding recurrent or residual tumor in this location. TRUS in evaluation of the source of postoperative eleva tion of prostate-specific antigen levels warrants further investigatio n.