NEGATIVE TRUS – GUIDED BIOPSY OF PROSTATE IN DIFFERENT GROUPS OF RAISED PSA LEVEL

Aims and Objectives 1. To determine the frequency of negative TRUS guided biopsy of Prostate in different groups of raised PSA level. 2. To determine the frequency of raised PSA level ( 4 ng/ml) in patients presenting with symptoms of enlarged prostate. Study Design: Cross Sectional survey. Setting: Department of Urology, Sheikh Zayed Hos-pital, Lahore. Duration of Study: Six Months.Sample Size: 90 cases. Subjects and Methods: Ninety patients fulfilling the selection criteria were identified. All the patients underwent TRUS guided prostate biopsy and Results evaluated on the basis of biopsy report. Results: This study included 90 patients. The age ran-ged from 48 – 80 years with a mean of 65.02 ± 8.32 years. PSA level range was from 4.7-230ng/ml; with mean PSA level of 24.12 ± 36.09.Out of 40 patients with PSA 4 – 10 ng/ml, 36 (90%) patient’s TRUS gui-ded biopsy was negative for malignancy. 26 (92.8%) out of 28 patients, with PSA 10 – 20 ng/dl the biopsy was negative, 9 (40.9%) out of 22 patients, biopsy was negative with PSA 20 ng/ml. Among 19 patients having positive TRUS guided biopsy 12 (63.1%) had well differentiated adenocarcinoma; 6 (31.5%) had moderately differentiated adenocarcinoma and 1 (5.2%) had poorly differentiated adenocarcinoma. Conclusion: Detection rate of carcinoma of prostate on TRUS guided biopsy according to serum PSA level is low in our setup, repeat serum PSA levels are re-commended after a period of one month with or with-out cover of antibiotics so that unnecessary TRUS bio-psies can be avoided.