A STUDY OF ULTRASONOGRAPHIC PATTERN AND HISTOLOGIC OUTCOME OF TRANSRECTAL ULTRASOUND GUIDED BIOPSIES IN PATIENTS WITH PROSTATIC CARCINOMA

Introduction: Transrectal ultrasound (TRUS) is one of the modalities for the evaluation of a patient with suspected carcinoma of the prostate. No local study had been done so by conducting this study we assessed the pattern of ultrasonographic findings and their histologic pattern in our local patient population. Objective: To find out the ultrasonographic pattern and histologic outcome of transrectal ultrasound guided biopsies in patients with prostatic carcinoma. Methodology: This cross sectional study was done at outpatient and Inpatient department of Urology DHQ Teaching Hospital D.G. Khan. Using non-probability consecutive sampling 384 consecutive patients presenting with clinical features or having positive digital rectal examination and fulfilling the inclusion and exclusion criteria were included in the study. All the patients underwent detailed history and physical examination by the researcher. Serum PSA levels was checked in all the patients. The area of abnormality was identified in the peripheral, central or transitional zone as well as the echogenicity of the lesion was noted as hypo/hyper or isoechoic. 12 core biopsies were taken from the area of abnormality as well as from other standard areas using extended 12 core biopsy technique. These were collected in separate jars, labeled and sent for histopathological analysis. Results: The mean age of patients was 63.20 +/- 7.96 years. According anatomical zone, 306 (79.7%) patients had peripheral, 18 (4.7%) had central and 60(15.6%) patients had transitional lesion. According to Echogenicity of lesions, 251(65.4%) of the patients had hypoechoic, 126(32.8%) had Isoechoic and 7 (1.8%) patients had hyperechoic echogenicity. According to histological outcome malignancy was present in 308(80.2%) of the patients. Conclusion: According to anatomical zone peripheral was the highest lesion followed by transitional and central. Hypoechoic was most followed by Isoechoic and hyperechoic echogenicity in our patients. According to histological outcome malignancy was present in 308(80.2%) of the patients, in which 236 (76.6%) had Peripheral, 16(5.2% had Central and 56(18.2%) patients transitional anatomical zones. Histological outcome (malignancy) was statistically associated with Peripheral anatomical zone, p-value = 0.01.