A Comparative Analysis of Sextant and Extended 5 – Region 13 Core Trans-rectal Ultrasound Guided Prostate Biopsy

Objective: To compare the diagnostic value of Extended 5 – Region (13 core) Trans-rectal Ultrasound guided Prostate Biopsy with Standard Sextant Biopsy. Materials and Methods: 60 patients underwent transrectal ultrasound guided biopsy of prostate. In addition to sextant biopsies, cores were taken from far lateral and mid regions of the gland. Pathological findings Principal, Mian Nawaz Sharif Medical College, Gujrat of the additional regions were compared to those of the sextant regions. Results: We performed 5 – region trans-rectal ultrasound guided prostate biopsy of 60 patients The reason for biopsy was abnormal digital rectal examination in 10 patients (16.7%), elevated PSA in 26 (43.3%) and combined abnormalities in 24 (40%). Out of these 60 cases, 37 (61.6%) came out to have prostate cancer. Of the cancer patients 5 (13.5% had an abnormal digital rectal examination, 14 (37.8%) had elevated PSA and 18 (48.6%) had both abnormalities. Among these 37 positive for carcinoma prostate cases, 22 patients were positive for prostate cancer in additional (zone 1, 3, 5) as well as sextant regions(zone 2, 4), 12 patients had cancer only in additional region 1, 3 and 5 and 3 patients were positive for prostate cancer in sextant regions alone. Conclusion: Five region technique of prostate biopsy is an efficient mean of significantly increasing the diagnostic yield of prostate biopsy in finding carcinoma of the prostate. We have found this technique to be safe, efficacious and superior to sextant biopsies in diagnosing prostate cancer in patients with a PSA level of less than 10 ng / ml.