Objective: To prospectively evaluate the efficacy of a Systematic Finger Guided (SFG) approach to transrectal Prostate Needle Biopsy (PNB).
Patients and methods: One hundred and eighty-nine sets of SFG PNB were performed on 145 men. At least four biopsy cores were taken systematically from apex to base on each side of the prostate, including suspicious areas if present. The SFG experience was compared to a literature cohort and to 14 patients who had both SFG and TRUS guided PNB.
Results: Of 111 SFG biopsy sets taken from 88 men with suspicious DRE, 53% were positive; 25%, 43% and 84% of men had a PSA of 0-4, 4.1-10 and >10 ng/ml respectively. With benign DRE's, positive biopsies were seen in 22% and 28% of those with a PSA 4.1-10 and >10 ng/ml respectively. Of 22 patients with two or more sets of SFG PNB's, 11 (50%) were positive on repeat PNB. Of the 14 patients with a mix of TRUS and SFG PNB's, six were concordant, four were positive on SFG only, and one on TRUS only (p=n.s.).
Conclusion: Results of SFG PNB's and TRUS PNB's are equivalent in patients with and without suspicious prostates on DRE, probably due to the systematic nature of the sampling and number of the samples taken.