EAU 2013 - Programme Book - YouMed

ESU Courses, 18 March
ESU Course 35
12.00 - 14.00 Ultrasound for the urologist - TRUS and TRUS guided biopsies
Orange Hall 2 - Level N-1
Indications for TRUS and biopsy
P. Hammerer, Braunschweig (DE)
Chair: P. Hammerer, Braunschweig (DE)
Practical aspects of TRUS and TRUS guided biopsies
P. Hammerer, Braunschweig (DE)
Indications for rebiopsy
V. Scattoni, Milan (IT)
Update on new technical developments
V. Scattoni, Milan (IT)
Aims and objectives
The purpose of this ESU course is to define the optimal transrectal ultrasound and to discuss new ultrasound
techniques for prostate cancer detection, as well as defining a new standard for transrectal ultrasoundguided
prostate biopsies. In addition, techniques to reduce morbidity and to increase patient acceptance will
be discussed. Transrectal ultrasound has been performed for more than 15 years, and this technique is now
an important part of prostate cancer diagnosis and staging. Anatomic studies of prostatectomy specimens
that defined the zonal anatomy of the prostate and provided a detailed mapping of the tumour location
have increased our understanding of transrectal ultrasound images, as well as enabling optimal placement
of the biopsy needles. The stage migration revealed by PSA-based screening has resulted in most tumours
being non-palpable at diagnosis. Therefore in the PSA arena, with tumours at an early stage (non-palpable
and sometimes ultrasonografically isoechoic) transrectal ultrasound is needed to enable sampling of all
relevant areas of the prostate including those that appear normal. The systematic sampling of the prostate
by the sextant biopsy technique improved the detection rate of prostate cancer over sampling hypoechoic or
palpable suspicious lesions. However, in men with initially negative biopsies a second set of sextant biopsies
will be positive in about 20-30%. Several groups have demonstrated that the sextant technique is inadequate
for sampling of larger prostates and they advocated additional samples. Will an increase of prostate biopsies
result in patient discomfort? Although some studies report no additional morbidity from the more extensive
biopsy protocols, it seems likely that discomfort for the patient would be increased. What can be done to
reduce pain and discomfort and improve tolerance for additional biopsies? Simple and efficacious methods
are now available to provide anaesthesia in men undergoing prostate biopsies.
Registration fee excluding VAT
EAU members € 32
Non-EAU members € 47
Residents (members/non-members) € 21
EAU Milan 2013
367
ESU Courses