Operation:
Transrectal ultrasonography of the prostate and ultrasound guided prostate biopsy.
Clinical Indications:
71 y.o. man who presents with an elevated PSA. The patient's PSAs are as follows: 5.3 January 5, 2013
He today presents for a biopsy. Digital rectal exam revealed an enlarged prostate, smooth without any palpable lesions.
Findings:
Serial transverse and longitudinal scannings of the prostate gland were obtained. The prostate gland was estimated to be 70 cc and transition zone is 51 cc.
No hypoechoic area is noted in the gland. Prostatic capsule is intact. Extracapsular extension was not noted.
Procedure:
The patient prepared for the biopsy with pre-procedure antibiotics and an enema. After informed consent was obtained, the patient was taken to the procedure room and placed in the L lateral decubitus position. A digital rectal exam was performed. The ultrasound probe was then inserted into the rectum and serial transverse prostate and SVs were inspected for areas of hypoechogenicity.
The probe was removed and beta-dyne was used to prep the rectum. The prostate was then anesthetized with 20 cc of 1% xylocaine. 14 biopsies were taken, with 1 biopsy from the anterior, apex, mid, base in the medial and lateral portion of the prostate bilaterally. At the conclusion of the biopsies, the rectum was inspected and appeared free of bleeding. The patient tolerated the procedure well and released from the exam room uneventfully.
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