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Prostatabiopsie

Durchführung im klinischen Alltag

Prostate biopsy

Procedure in the clinical routine

  • CME Zertifizierte Fortbildung
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Zusammenfassung

Im Laufe des letzten Jahrzehnts ist die Sterblichkeitsrate des Prostatakarzinoms um 25 % gesunken. Eine herausragende Rolle spielt die Anwendung der urologisch-fachspezifischen Vorsorge. Das prostataspezifische Antigen (PSA) und die TRUS (transrektaler Ultraschall)-gesteuerte topographisch zuordenbare Gewebeentnahme mit dem histopathologischen Ergebnis liefern die wesentlichen Informationen zur Risikostratifizierung, Diagnostik und Therapieentscheidung. Der vermehrte Einsatz des PSA hat zu einer höheren Identifizierung asymptomatischer Patienten geführt, die einer weiteren Abklärung bedürfen. Ein eindeutiger Standard für den klinischen Umgang mit den jeweiligen Verfahren der Prostatabiopsie sowie den Umgang mit der stetigen technischen Optimierung, insbesondere mit der Entwicklung der Bildgebung, besteht nicht. Basis sämtlicher Techniken ist der TRUS. Im Rahmen dieser Übersicht werden aktuelle Grundlagen, Techniken, neue Ansätze und Instrumentarien der Prostatastanzbiopsie unter bildgebender Kontrolle im Rahmen des strukturierten Ausbildungsansatzes vorgestellt.

Abstract

Over the last decade there has been a 25 % decrease in the mortality rates for prostate cancer. The reasons for this significant decrease are most likely associated with the application of urological screening tests. The main tools for early detection are currently increased public awareness of the disease, prostate-specific antigen (PSA) tests and transrectal ultrasound (TRUS) guided topographically assignable biopsy sampling. Together with the histopathological results these features provide essential information for risk stratification, diagnostics and therapy decisions. The evolution of prostate biopsy techniques as well as the use of PSA testing has led to an increased identification of asymptomatic men, where further clarification is necessary. Significant efforts and increased clinical research focus on determining the appropriate indications for a prostate biopsy and the optimal technique to achieve better detection rates. The most widely used imaging modality for the prostate is TRUS; however, there are no clearly defined standards for the clinical approach for each individual biopsy procedure, dealing with continuous technical optimization and in particular the developments in imaging. In this review the current principles, techniques, new approaches and instrumentation of prostate biopsy imaging control are presented within the framework of the structured educational approach.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Enzmann, T. Tokas, K. Korte, M. Ritter, P. Hammerer, L. Franzaring, H. Heynemann, H.-W. Gottfried, H. Bertermann, M. Meyer-Schwickerath, B. Wirth und A. Pelzer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Klinikum Brandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg Theodor Fontane, Brandenburg an der Havel, Deutschland

    T. Enzmann

  2. Urologische Klinik des Ev. Luth. Diakonissenkrankenhauses, Akademisches Lehrkrankenhaus der Christian-Albrechts-Universität zu Kiel, Knuthstr. 1, 24939, Flensburg, Deutschland

    T. Tokas, K. Korte & T. Loch

  3. Klinik für Urologie, Universitätsmedizin Mannheim, Mannheim, Deutschland

    M. Ritter

  4. Klinik für Urologie und Uroonkologie, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Deutschland

    P. Hammerer

  5. Kemperhof, Urologie und Kinderurologie, Gemeinschaftsklinikum Mittelrhein, Koblenz, Deutschland

    L. Franzaring

  6. Universitätsklinik und Poliklinik für Urologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland

    H. Heynemann

  7. Urologie und Kinderurologie, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Deutschland

    H.-W. Gottfried

  8. Urologische Gemeinschaftspraxis Prüner Gang, Kiel, Deutschland

    H. Bertermann

  9. Uologische Praxisklinik Essen, Essen, Deutschland

    M. Meyer-Schwickerath

  10. Urologie, Hospital zum Heiligen Geist, Kempen, Deutschland

    B. Wirth

  11. Urologische Klinik, Klinikum Ingolstadt, Ingolstadt, Deutschland

    A. Pelzer

Authors
  1. T. Enzmann
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  2. T. Tokas
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  3. K. Korte
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  4. M. Ritter
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  5. P. Hammerer
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  6. L. Franzaring
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  7. H. Heynemann
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  8. H.-W. Gottfried
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  9. H. Bertermann
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  10. M. Meyer-Schwickerath
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  11. B. Wirth
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  12. A. Pelzer
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  13. T. Loch
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Corresponding author

Correspondence to T. Loch.

Additional information

CME-Beitrag des Arbeitskreises Bildgebende Systeme der Akademie der Deutschen Urologen mit Inhalten aus den DEGUM-zertifizierten Fortbildungen.

Die hier beschriebenen Techniken können in den Kursen der Akademie der Deutschen Urologen mit praktischen Übungen CME- und DEGUM-zertifiziert als Basisfertigkeit vom Urologen erlernt und in Spezialkursen vertieft werden.

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Enzmann, T., Tokas, T., Korte, K. et al. Prostatabiopsie. Urologe 54, 1811–1822 (2015). https://doi.org/10.1007/s00120-015-4025-7

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  • DOI: https://doi.org/10.1007/s00120-015-4025-7

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