Abstract
We report a rare case of hematoma in Retzius’ space in a 62-year-old man who underwent transrectal prostate biopsy using an endocavitary, end-fire, convex probe. Clinical symptoms resolved spontaneously after catheter placement and appropriate antibiotic therapy. Transrectal ultrasound 1 month later showed partial resolution of the hematoma. Based on the analysis of this unusual complication, we demonstrate the effectiveness of transrectal biopsy as compared to transperineal biopsy in detecting cancer of the anterior prostate. We have also analyzed the various factors that may be the reason why core biopsy harvested in this “hidden” area may be inadequate.
Riassunto
Noi abbiamo riportato un raro caso di ematoma dello scavo del Retzius in un uomo di 62 anni sottoposto a biopsia prostatica transrettale ecoguidata con utilizzo di sonda convex “end-fire”. Il quadro clinico si è risolto spontaneamente dopo pozionamento di foley ed adeguata terapia antibiotica. Dopo un mese all’ecografia prostatica transrettale si repertava parziale risoluzione dell’ematoma. Dall’analisi di questa insolita complicanza abbiamo cercato di dimostrare l’efficacia della tecnica bioptica transrettale rispetto all’approccio transperineale nel tasso di rilevamento del carcinoma prostatico nella porzione anteriore della ghiandola ed abbiamo anche preso in esame i vari fattori che possono esser motivo in questa zona anatomica “nascosta” di un campionamento bioptico non adeguato.
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Conflict of interest
Lucio Dell’Atti declares that he has no conflict of interest related to this paper.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. The patient provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to his identification.
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Dell’Atti, L. Hematoma in Retzius’ space following US-guided prostate biopsy: evidence of the diagnostic accuracy using transrectal end-fire probe in the anterior prostate gland. J Ultrasound 17, 71–73 (2014). https://doi.org/10.1007/s40477-013-0058-1
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DOI: https://doi.org/10.1007/s40477-013-0058-1