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Biopsie der Prostata

Update zu Indikation, Durchführung und zukünftiger Entwicklung

Prostate biopsy

Update for indication, procedure, and future developments

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Zusammenfassung

Die transrektal ultraschallgestützte Prostatabiopsie mit der Entnahme von ≥ 10 Proben, die nach lateral ausgerichtet sein sollen, unter antibiotischem Schutz mit begleitendem Einsatz einer Lokalanästhesie ist der Standard bei der primären Abklärung eines suspekten Prostatabefunds. Die Indikation zur Biopsie wird unter Berücksichtigung des Ergebnisses der transrektalen Tastuntersuchung, des Serum-PSA-Werts, des patientenindividuellen Wunsches und seiner Komorbidität gestellt. Der Einsatz multiparametrischer bildgebender Verfahren vor und während der Durchführung der Primär- oder Rebiopsie zur Identifikation suspekter Prostatabefunde bleibt Gegenstand laufender Untersuchungen. Erweiterte Biopsieprotokolle bedürfen zusätzlicher klinischer Untersuchungen bevor sie zu neuen Standards in der Diagnostik werden können. Dieser Beitrag gibt einen aktuellen Überblick über die Indikation und die Techniken der Prostatabiopsie.

Abstract

Transrectal ultrasound-guided prostate biopsy is considered the gold standard in the primary investigation of a suspicious prostate-related finding. The procedure can be carried out with ten probes or more on the lateral side of the prostate, after administering antibiotic prophylaxis and applying local anesthesia. The indication for a biopsy depends on the results of the digitorectal examination, on the serum prostate-specific antigen level, on the individual patient’s wish and on his comorbidities. Whether multiparametric imaging should be used before or during the course of a primary or repeated biopsy in order to identify suspicious prostate lesions is the subject of current investigations. Extended biopsy protocols require further clinical investigations before they can become the new standard in the diagnostic work-up. This review delivers an update on the indication for, and technique of, prostate biopsies.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Machtens, A. Roosen, C.G. Stief und M.C.Truß geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Marienkrankenhaus Bergisch Gladbach, Dr.-Robert-Koch-Straße 16, 51465, Bergisch Gladbach, Deutschland

    S. Machtens

  2. Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Deutschland

    A. Roosen & C.G. Stief

  3. Urologische Klinik, Klinikzentrum Nord, Dortmund, Deutschland

    M.C. Truß

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  1. S. Machtens
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  2. A. Roosen
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  3. C.G. Stief
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  4. M.C. Truß
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Correspondence to S. Machtens.

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Machtens, S., Roosen, A., Stief, C. et al. Biopsie der Prostata. Urologe 53, 1046–1051 (2014). https://doi.org/10.1007/s00120-014-3536-y

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  • DOI: https://doi.org/10.1007/s00120-014-3536-y

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