Simultaneous transurethral resection of prostate and prostate needle biopsy in patients with acute urinary retention and elevated prostate specific antigen levels.

BACKGROUND To evaluate the safety and accuracy of simultaneous transrectal ultrasonography (TRUS)-guided prostate biopsy and transurethral resection of prostate (TURP), patients with acute urinary retention (AUR) who underwent simultaneous prostate biopsy and TURP were compared with those treated by TURP alone. METHODS From July 2000 to Jun 2004, 21 patients older than 70 years with AUR were included in each group. Patients with elevated prostate specific antigen (PSA) levels > 4 ng(/ml) underwent TURP and TRUS-guided biopsy simultaneously (group I), while those with normal PSA levels < 4 ng(/ml) received TURP alone (group II). The average ages of group I and group II patients were 72.4 and 72.5 years. RESULTS In group I, 4 patients (19%) were diagnosed with prostate cancer; 2 had metastasis and received hormone therapy; and 1 had localized cancer and was treated with brachytherapy. An 82-year-old patient with localized cancer opted for watchful waiting. Compared to group II, patients in group I did notshow aggregated morbidity, such as prolonged hospital stay, hematuria, or fever. CONCLUSION Simultaneous TURP and TRUS-guided biopsy in healthy AUR patients does not increase the risk of morbidity. Furthermore, with this approach patients can recover from the stress of AUR and have a definite diagnosis of their condition.