Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2219-2226
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2219
Role of Hiraoka's transurethral detachment of the prostate combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of prostate cancer
Chun-Yu Pan, Bin Wu, Zi-Chuan Yao, Xian-Qing Zhu, Yun-Zhong Jiang, Song Bai
Chun-Yu Pan, Bin Wu, Zi-Chuan Yao, Xian-Qing Zhu, Yun-Zhong Jiang, Song Bai, Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Bai S had full access to all the data in the study and is responsible for the integrity of the data and the accuracy of the data analysis; Bai S conceived and designed the study, obtained funding and other figures; Pan CY, Yao ZC and Zhu XQ contributed to acquisition of data, analysis and interpretation of data; Pan CY drafted the manuscript, critically revised the manuscript for important intellectual content, and analyzed the data.
Supported by Shengjing Hospital Science and Technology Program, No. MC05.
Institutional review board statement: Ethical approval (Ethics Committee No. 2018PS496k) was provided by the Institutional Research and Ethics Committee of the Shengjing Hospital Affiliated China Medical University in Shengyang, China.
Informed consent statement: Informed consent was obtained from all eligible patients.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Song Bai, MD, PhD, Assistant Professor, Doctor, Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. bais@sj-hospital.org
Received: January 2, 2020
Peer-review started: January 2, 2020
First decision: February 26, 2020
Revised: March 26, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: June 6, 2020
ARTICLE HIGHLIGHTS
Research background

After repeated negative biopsies, persistent suspicion of prostate cancer (PCa) due to a rising prostate-specific antigen (PSA) level is a serious challenge in clinical practice.

Research motivation

Transurethral detachment of the prostate (TUDP) combined with biopsy of the peripheral zone during the same session is a method which may improve the PCa detection rate by obtaining a complete sample which simultaneously includes the entire transition, peripheral, and anterior fibrous zones.

Research objectives

Our aim was to determine the role of Hiraoka's TUDP combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of PCa.

Research methods

We retrospectively evaluated the records of 10 patients who were eligible for inclusion in our hospital between December 2012 and August 2017. Patient demographics, a family history of PCa, the number of biopsies, prostate volume, pathological examination, and perioperative PSA level were obtained.

Research results

Two of 10 patients were pathologically diagnosed with PCa after surgery; the Gleason scores were 4 + 4 and 4 + 3, respectively. Both of the patients subsequently underwent laparoscopic radical prostatectomy. The median PSA levels preoperatively, and 3 mo and 1 year postoperatively in the other eight patients who were diagnosed with benign prostate hyperplasia after surgery were 19.10 ng/mL, 1.10 ng/mL, and 1.15 ng/mL, respectively. The adjusted P values of the 3-mo and 1-year post-operative PSA level vs pre-operative PSA level were 0.003 and 0.026, respectively. None of the patients had rising PSA levels or PCa detected after a median 35 mo of follow-up.

Research conclusions

TUDP combined with peripheral zone biopsy may improve the PCa detection rate in patients with repeated negative biopsies.

Research perspectives

The PSA level declined rapidly in patients who had negative pathological examinations after TUDP, which remained stable 1 year after surgery.