Transurethral Biopsy Research Articles

The Role of Repeat Transurethral Biopsy in Stage a Carcinoma of the Prostate

There is a significant difference in survival of patients with stages A1 and A2 prostatic adenocarcinoma. Therefore, it is important to distinguish focal occult adenocarcinoma from diffuse occult adenocarcinoma. However, that may be impossible from a single transurethral resection of the prostate. This study was designed to determine if repeat transurethral biopsy would be helpful in defining the extent of stage A disease. Between January 1970 and January 1976, 27 of 61 patients with stage A adenocarcinoma of the prostate were selected for repeat transurethral biopsy of the prostate 3 months after the initial diagnosis. All 27 patients had a focus or focal adenocarcinoma of the prostate at the initial resection. Seven patients (26 per cent) were found to have significant residual tumor at repeat resection and were reclassified as stage A2. Three patients were found to have a single focus of adenocarcinoma on repeat biopsy. Thus, 37 per cent of the study group of patients had residual carcinoma after initial diagnosis by transurethral resection. Repeat transurethral biopsy is helpful in defining the extent of stage A disease and formulating a rational plan of therapy.

Pitfalls in Clinical Staging of Bladder Tumors

Errors in clinical staging of bladder carcinoma occur in about 50 per cent of patients. Sources of error include (1) a variable assortment of diagnostic studies performed, (2) inexactitudes inherent in the diagnostic measures employed, (3) insufficient corroboration by surgical and pathologic staging, (4) the lack of a satisfactory means for detecting micrometastases, and (5) a generalized confusion regarding the multiple classifications available for clinical staging. More precise clinical staging will be influential in treatment decision-making and in prognosis. Minimum requirements for clinical staging of the primary tumor currently include complete examination, excretory urography, cystoscopy, bimanual examination under anesthesia, and transurethral resection or biopsy. Polycystography, triple contrast cystograpy and arteriography may be helpful occasionally to document muscle invasion. Pedal lymphangiography and lymphography can in selected cases be helpful in detecting otherwise silent nodal involvement in spite of its inability to demonstrate many primary or regional lymph nodes. Familiarity with the above diagnostic options and the advantages and limitations of each is essential for each physician caring for a patient with bladder carcinoma. Conversion to TNM classification for bladder carcinoma that is similar to that of the UICC seems appropriate (1) because of its more rational approach to extent of involement by primary tumor, lymph node and distant sites, and (2) in order for our western hemisphere urologists to communicate better with our colleagues from around the globe. Such a system is now under consideration by a subcommittee of the American Joint Committee on Staging and End Result Reporting.

Endoscopy and the detection of genitourinary carcinoma.

Endoscopy in the detection of urinary tract cancer is one of the primary tools of the urologist. It is used in the localization of bleeding sites, the systematic follow-up in detecting recurrent malignancies, the pathologic staging of carcinoma of the bladder through transurethral biopsy, and the identification and biopsy of primary transitional cell carcinoma of the prostate. It is also a prime tool in the diagnosis of ureteral and pelvic tumors through retrograde pyelography, brush biopsy, and urine collection for cytology. Nephroscopy is now also possible for the obscure lesions difficult to diagnose otherwise. Urethroscopy is also important in detecting malignant changes. The various sites for urologic cancer, their incidence, and the role of endoscopy in relation to other means of diagnosis and management are discussed.

Survival of Patients with Incidentally Found Microscopic Cancer of the Prostate: Results of a Clinical Trial of Conservative Treatment

No AccessJournal of Urology1 Dec 1972Survival of Patients with Incidentally Found Microscopic Cancer of the Prostate: Results of a Clinical Trial of Conservative Treatment David P. Byar and The Veterans Administration Cooperative Urological Research Group David P. ByarDavid P. Byar More articles by this author and The Veterans Administration Cooperative Urological Research Group More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)60904-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1972 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byZhang G, Wasserman N, Sidi A, Reinberg Y and Reddy P (2018) Long-Term Followup Results After Expectant Management of Stage A1 Prostatic CancerJournal of Urology, VOL. 146, NO. 1, (99-103), Online publication date: 1-Jul-1991.Zincke H, Blute M, Fallen M and Farrow G (2018) Radical Prostatectomy for Stage a Adenocarcinoma of the Prostate: Staging Errors and their Implications for Treatment Recommendations and Disease OutcomeJournal of Urology, VOL. 146, NO. 4, (1053-1058), Online publication date: 1-Oct-1991.Lowe B and Barry J (2018) The Predictive Accuracy of Staging Transurethral Resection of the Prostate in the Management of Stage A Cancer of the Prostate: A Comparative EvaluationJournal of Urology, VOL. 143, NO. 6, (1142-1145), Online publication date: 1-Jun-1990.Stillwell T, Malek R, Engen D and Farrow G (2018) Incidental Adenocarcinoma After Open Prostatic AdenectomyJournal of Urology, VOL. 141, NO. 1, (76-78), Online publication date: 1-Jan-1989.Lowe B and Listrom M (2018) Incidental Carcinoma of the Prostate: An Analysis of the Predictors of ProgressionJournal of Urology, VOL. 140, NO. 6, (1340-1344), Online publication date: 1-Dec-1988.McNeal J, Price H, Redwine E, Freiha F and Stamey T (2018) Stage A Versus Stage B Adenocarcinoma of the Prostate: Morphological Comparison and Biological SignificanceJournal of Urology, VOL. 139, NO. 1, (61-65), Online publication date: 1-Jan-1988.Mansi J, Berger U, Wilson P, Shearer R and Coombes R (2018) Detection of Tumor Cells in Bone Marrow of Patients with Prostatic Carcinoma by Immunocytochemical TechniquesJournal of Urology, VOL. 139, NO. 3, (545-548), Online publication date: 1-Mar-1988.Epstein J, Paull G, Eggleston J and Walsh P (2018) Prognosis of Untreated Stage A1 Prostatic Carcinoma: A Study of 94 Cases with Extended FollowupJournal of Urology, VOL. 136, NO. 4, (837-839), Online publication date: 1-Oct-1986.Blute M, Zincke H and Farrow G (2018) Long-Term Followup of Young Patients with Stage a Adenocarcinoma of the ProstateJournal of Urology, VOL. 136, NO. 4, (840-843), Online publication date: 1-Oct-1986.Sestili M, Norris J, Lipschultz L and Smith R (2018) Dunning Adenocarcinoma in Tissue Culture: Isolation of a Cloned Cell Line, R3327H-G8-A1Journal of Urology, VOL. 127, NO. 4, (823-825), Online publication date: 1-Apr-1982.Cantrell B, DeKlerk D, Eggleston J, Boitnott J and Walsh P (2018) Pathological Factors that Influence Prognosis in Stage a Prostatic Cancer: the Influence of Extent Versus GradeJournal of Urology, VOL. 125, NO. 4, (516-520), Online publication date: 1-Apr-1981.Donohue R, Fauver H, Whitesel J and Pfister R (2018) Staging Prostatic Cancer: A Different DistributionJournal of Urology, VOL. 122, NO. 3, (327-329), Online publication date: 1-Sep-1979.Catalqna W and Scott W (2018) Carcinoma of the Prostate: A RevivewJournal of Urology, VOL. 119, NO. 1, (1-8), Online publication date: 1-Jan-1978.Alyea E, Dees J and Glenn J (2018) An Aggressive Approach to Prostatic CancerJournal of Urology, VOL. 118, NO. 1 Part 2, (211-215), Online publication date: 1-Jul-1977.Heaney J, Chang H, Daly J and Prout G (2018) Prognosis of Clinically Undiagnosed Prostatic Carcinoma and the Influence of Endocrine TherapyJournal of Urology, VOL. 118, NO. 2, (283-287), Online publication date: 1-Aug-1977.Boxer R, Kaufman J and Goodwin W (2018) Radical Prostatectomy for Carcinoma of the Prostate: 1951–1976. A Review of 329 PatientsJournal of Urology, VOL. 117, NO. 2, (208-213), Online publication date: 1-Feb-1977.Mcmillen S and Wettlaufer J (2018) The Role of Repeat Transurethral Biopsy in Stage a Carcinoma of the ProstateJournal of Urology, VOL. 116, NO. 6, (759-760), Online publication date: 1-Dec-1976.Cosgrove M and Kaempf M (2018) Prostatic Cancer RevisitedJournal of Urology, VOL. 115, NO. 1, (79-81), Online publication date: 1-Jan-1976.Krauss D and Lilien O (2018) The Benign Killer: Carcinoma of the ProstateJournal of Urology, VOL. 113, NO. 6, (820-823), Online publication date: 1-Jun-1975.Ray G, Cassady J and Bagshaw M (2018) External-Beam Megavoltage Radiation Therapy in the Treatment of Post-Radical Prostatectomy Residual or Recurrent Tumor: Preliminary ResultsJournal of Urology, VOL. 114, NO. 1, (98-101), Online publication date: 1-Jul-1975.Correa R, Anderson R, Gibbons R and Mason J (2018) Latent Carcinoma of the Prostate—Why the Controversy ?Journal of Urology, VOL. 111, NO. 5, (644-646), Online publication date: 1-May-1974. Volume 108Issue 6December 1972Page: 908-913 Advertisement Copyright & Permissions© 1972 by The American Urological Association Education and Research, Inc.MetricsAuthor Information David P. Byar More articles by this author The Veterans Administration Cooperative Urological Research Group More articles by this author Expand All Advertisement PDF downloadLoading ...

The current status of transurethral resection in the diagnosis and therapy of carcinoma of the urinary bladder

Problems in the pathology of bladder tumours are discussed and various classifications are proposed. Having favourable prognosis, the tumours generally referred to as papillomas are not classified as carcinoma. The importance of pretherapeutic biopsy is emphasized, the advantages of transurethral biopsy and its technique are described. All superficial tumours of stage A, if accessible, and a fairly large proportion of highly differentiated carcinomas of stage B1 may be radically excised by the transurethral route. If infiltrative malignant growth involves deeper muscle layers of the bladder wall, radical elimination of the tumour by TUR is no longer possible. On the other hand, extensive, more radical procedures are hazardous and often fatal. The age of the patient is a decisive factor. Radical excision of stage C and D tumours is unfeasible by existing procedures. However, here too, palliative TUR in combination with high-voltage radiotherapy gives considerable benefit. The results obtained in 268 cases of bladder carcinoma by TUR treatment alone and the five-year survivals in 171 cases are described.

Comparison of Needle Biopsy and Transurethral Resection Biopsy in the Diagnosis of Carcinoma of the Prostate

Comparison of Needle Biopsy and Transurethral Resection Biopsy in the Diagnosis of Carcinoma of the Prostate

経尿道的膀胱腫瘍切除術の研究

Fifty-five transurethral resections were performed on 46 cases of bladder tumor in the period between November 1959 and March 1964, at the Jikei University Hospital.The operative technique consists of removing all the tumor tissue down to the level of the bladder wall at first, and the base is then resected carefully, attempting to resect down to the halfway level of the bladder muscle layer, usually to the depth of one loop.We stage our tumors as to depth of extension according to the method of Jewett. The staging of tumors by transurethral biopsy and bimanual pelvic examination is extremely important from not only a prognostic but a therapeutic viewpoint.We follow the histological grading as classified by Royce and Ackerman, namely, Grades I, II, III and IV. Grade I is not malignant except for the tendency to recur.The ages of the patients varied between 28 and 78 years; the average age at operation was 58 years. Men predominated over women 39:7, or 5. 6:1.The sterile distilled water was used as irrigating fluid in majority of the cases to prevent implantation of the loose tumor cells to the vesical or urethral mucosa.The biggest tumor tissue resected weighed 30 grams, but the average weight was 3.4 grams.The length of the time needed for the resecting procedure varied between 5 and 70 minutes: the average time was 28 minutes.The average blood loss was about 68cc during the resecting procedure, macroscopic hematuria disappeared in 3 days and indwelling catheter was removed on the 3rd postoperative day on the average.The venous blood specimens were taken before and immediately after the resecting procedure to examine the changes of the serum Na, K, Cl and BUN levels. The serum Na decreased 1.5mEq/L. Cl decreased 1mEq/L, BUN decreased 0.4mg/dl and only K increased 0.2mEq/L on the average after the resecting procedure.The operative and postoperative complications consisted of 31 urinary infections, 3 vesical perforations, 2 serum hepatitis, an acute cardiac failure, an acute pneumonia, an urethro-rectal fistula, an epididymitis and a meatal stricture.The histologicol pattern of the tumors in this series consisted of 40 transitional cell carcinomas, an undifferentiated carcinoma, an epidermoid carcinoma, 2 adenocarcinoma and 2 mucinous adenocarcinomas. Their depth of infiltration according to the Jewett's staging were: stage 0 in 13 cases, stage A in 7 cases, stage B1 in 10 cases, stage B2 in 8 cases and stage C in 8 cases.The low grade and low stage group revealed best survival rate; 21 of the 24 cases or 84% have been surviving more than 13 months and 19 of them are known to be free of tumor. The others are: low grade and high stage group 50% and high grade and low stage group 50% and high grade and high stage group 54%.Though my experience is still limited and follow up period is not long enough, I feel that transurethral resection is the treatment of choice in the vast majority of bladder tumors, especially for treating low grade and low stage lesions.

Needle Biopsy of the Prostate: A Re-evaluation

Needle Biopsy of the Prostate: A Re-evaluation

The Role of Perineal Punch Biopsy in the Diagnosis and Treatment of Carcinoma of the Prostate

No AccessJournal of Urology1 Mar 1960The Role of Perineal Punch Biopsy in the Diagnosis and Treatment of Carcinoma of the Prostate Miles W. Thomley, James B. Jamison, and W. Ansel Derrick Miles W. ThomleyMiles W. Thomley More articles by this author , James B. JamisonJames B. Jamison More articles by this author , and W. Ansel DerrickW. Ansel Derrick More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)65709-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1960 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited by Addonizio J and Kapoor S (1976) Perineal seeding of prostatic carcinoma after needle biopsyUrology, 10.1016/0090-4295(76)90293-4, VOL. 8, NO. 5, (513-515), Online publication date: 1-Nov-1976. Puigvert A and Vicente J (1975) Nuestra experiencia en el tratamiento combinado del carcinoma de la prostataActa Endoscopica, 10.1007/BF03025238, VOL. 5, NO. 1, (21-32), Online publication date: 1-Jan-1975. Purser B, Robinson B and Mostofi F (2018) Comparison of Needle Biopsy and Transurethral Resection Biopsy in the Diagnosis of Carcinoma of the ProstateJournal of Urology, VOL. 98, NO. 2, (224-228), Online publication date: 1-Aug-1967.Labardini M and Nesbit R (2018) Perineal Extension of Adenocarcinoma of the Prostate Gland After Punch BiopsyJournal of Urology, VOL. 97, NO. 5, (891-893), Online publication date: 1-May-1967.Denton S, Valk W, Jacobson J and Kettunen R (2018) Comparison of the Perineal Needle Biopsy and the Transurethral Prostatectomy in the Diagnosis of Prostatic Carcinoma: An Analysis of 300 CasesJournal of Urology, VOL. 97, NO. 1, (127-129), Online publication date: 1-Jan-1967.Wendel R and Evans A (2018) Complications of Punch Biopsy of the Prostate GlandJournal of Urology, VOL. 97, NO. 1, (122-126), Online publication date: 1-Jan-1967.Arduino L and Murphy F (2018) Carcinoma of the Prostate: Use of the Franseen Needle for Perineal Prostatic BiopsyJournal of Urology, VOL. 89, NO. 5, (732-736), Online publication date: 1-May-1963.Campbell J, Thomley M and Parsons R (2018) Complications of Radical Prostatic SurgeryJournal of Urology, VOL. 89, NO. 2, (253-254), Online publication date: 1-Feb-1963. Volume 83Issue 3March 1960Page: 305-307 Advertisement Copyright & Permissions© 1960 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Miles W. Thomley More articles by this author James B. Jamison More articles by this author W. Ansel Derrick More articles by this author Expand All Advertisement PDF downloadLoading ...

Methods of Diagnosis of Carcinoma of the Prostate: A Comparison of Clinical Impression, Prostatic Smear, Needle Biopsy, Open Perineal Biopsy and Transurethral Biopsy

Methods of Diagnosis of Carcinoma of the Prostate: A Comparison of Clinical Impression, Prostatic Smear, Needle Biopsy, Open Perineal Biopsy and Transurethral Biopsy