ABSTRACT
In many clinical situations a patient affected by pre-cancerous prostatic lesions, suspected cancer or true cancer (assessed through biopsies or incidentally) must undergo iterative bioptic examinations. Three groups can be sub-divided: A) Patients with no previous endoscopic resection. B) Patients with previous endoscopic resection for BPH. C) Patients with previous RP for cancer. A persistent clinical suspicion for high PSA, a bioptic assessment for Ca T1c or PIN belong to the first group. A suspected cancer in a patient who had already undergone TUR, or a T1a neoplasia assessed incidentally, or PIN found in the resected fragments constitute the second group. A suspected local relapse after a RP characterizes the third group. In 28 cases of these clinical diagnoses, we have applied a new method of bioptic trans-urethral sampling. We used an eco-reflectant, flexible needle and applied it under endoscopic vision to the transitional zone or to tissues of the already resected prostatic fossa. In the first case these biopsies were integrative of the usual randomized biopsies. If transrectal ultrasound had given evidence of altered structures, biopsy was carried out with selective ultrasound guided technique. This procedure has proved to be minimally invasive, easy to carry out and particularly adapted to bioptise zones that are easier to reach transurethrally or tissues with low thickness.
