**Meet the editor**

Dr. Nabil K. Bissada helds position of Professor and program Director in the Department of Urology at University of Arkansas for Medical Sciences, where he is also an Executive Vice Chairman. Among numerous important positions Dr. Bissada is also a President of Arkansas Urological Society. With the reputation as a master surgeon, his operative techniques are widely quoted. In his

career, Dr. Bissada treated patients in 5 continents. He published 21 books and book chapters and authored over 300 publications.

Contents

**Preface VII** 

Chapter 1 **The Development of the Modern Prostate Biopsy 1**  Lehana Yeo, Dharmesh Patel, Christian Bach, Athanasios Papatsoris, Noor Buchholz, Islam Junaid and Junaid Masood

Chapter 2 **Radical Transurethral Resection of the Prostate: A Possible Radical Procedure Against Localized Prostate Cancer with Almost No Postoperative Urinary Incontinence 19** 

Masaru Morita and Takeshi Matsuura

Chapter 3 **Future Aspects of Prostate Biopsy – The Use of Primary** 

Cinthia Fuentealba and Leonardo Badinez

Chapter 4 **Technical Advices for Prostate Needle Biopsy Under Transrectal Ultrasound Guidance 55**  Makoto Ohori and Ayako Miyakawa

Chapter 5 **The Use of Models to Predict the Presence and** 

Chapter 6 **The Role of Anticoagulant Therapy During Prostate Biopsy 77** 

Yan-gao Man

**Biopsy: Evidence, Utility and Cost-Benefit 35** 

Stéphane Larré, Richard Bryant and Freddie Hamdy

Chapter 7 **Malignant Transformation and Stromal Invasion from** 

Chapter 8 **Strategies for Repeat Prostate Biopsies 113**  Sisir Botta and Martha K. Terris

**Circulating Prostate Cells to Select Patients for Prostate** 

Nigel P. Murray, Eduardo Reyes, Nelson Orellana, Ricardo Dueñas,

**Aggressiveness of Prostate Cancer on Prostate Biopsy 63** 

F. Zaman, C. Bach, P. Kumar, I. Junaid, N. Buchholz and J. Masood

**Normal Appearing Prostate Tissues: True or False? 91** 

## Contents

#### **Preface XI**


Preface

Prostate cancer is the most common non-skin cancer, accounting for one third of all visceral cancers and the second leading cause of cancer-related death for men in the United States and is a very common cancer in developed nations. Prostate cancer incidence rates rose in the 1980s, reflecting improvement in detection and diagnosis through the widespread use of PSA. The trend in death rates in prostate cancer increased in the 1970s and 1980s then declined in the last decades. This may reflect a wider use of radical prostatectomy in localized prostate cancer especially with better understanding of the anatomical locations of the neurovascular bundles. Likewise, the reduction of reported incontinence and erectile dysfunction after radical prostatectomy in recent studies as well as the advancements in radiotherapy for prostate cancer may have contributed to this observed decline. Another possible explanation is the increased early detection of prostate cancer following the introduction of PSA screening. Whether this reduction is related to PSA screening or

Prostate biopsy is the definitive modality in diagnosing prostate cancer. Numerous publications have addressed prostate biopsy in the last several decades. The crucial need for addressing the various aspects of prostate biopsy in a comprehensive volume remained unanswered until now. I hope that this book authored by many recognized

**Professor Nabil Kaddis Bissada** 

University of Arkansas for Medical Sciences

Department of Urology

USA

not will continue to be a subject of intense debate.

world authorities in prostate cancer will provide this crucial need.

## Preface

Prostate cancer is the most common non-skin cancer, accounting for one third of all visceral cancers and the second leading cause of cancer-related death for men in the United States and is a very common cancer in developed nations. Prostate cancer incidence rates rose in the 1980s, reflecting improvement in detection and diagnosis through the widespread use of PSA. The trend in death rates in prostate cancer increased in the 1970s and 1980s then declined in the last decades. This may reflect a wider use of radical prostatectomy in localized prostate cancer especially with better understanding of the anatomical locations of the neurovascular bundles. Likewise, the reduction of reported incontinence and erectile dysfunction after radical prostatectomy in recent studies as well as the advancements in radiotherapy for prostate cancer may have contributed to this observed decline. Another possible explanation is the increased early detection of prostate cancer following the introduction of PSA screening. Whether this reduction is related to PSA screening or not will continue to be a subject of intense debate.

Prostate biopsy is the definitive modality in diagnosing prostate cancer. Numerous publications have addressed prostate biopsy in the last several decades. The crucial need for addressing the various aspects of prostate biopsy in a comprehensive volume remained unanswered until now. I hope that this book authored by many recognized world authorities in prostate cancer will provide this crucial need.

**Professor Nabil Kaddis Bissada** 

Department of Urology University of Arkansas for Medical Sciences USA

**1** 

*UK* 

**The Development of the** 

**Modern Prostate Biopsy** 

*Barts and the London NHS Trust* 

Noor Buchholz, Islam Junaid and Junaid Masood

Lehana Yeo, Dharmesh Patel, Christian Bach, Athanasios Papatsoris,

In the 1950s prostate cancer was known to occur in about 20% of men over the age of 55 and was the cause of death in about 5% of white men over the age of 50 (Huggins and Johnson, 1947). It accounted for 90% of all male genital cancers and 63% of male genitourinary cancers and it was believed that 5-10% of prostatic cancers were diagnosed early enough to permit operation with a reasonable chance of cure (Kaufman et al., 1954). Clearly diagnosis

The current accepted practice of diagnosing prostate cancer relies on histopathological examination of prostatic tissue obtained through transrectal ultrasound (TRUS) guided biopsy of the gland (Heidenreich et al, 2010). The TRUS-guided transrectal method of obtaining prostatic tissue has been described since the mid-1980s but before then, other

This chapter describes the development of the modern prostate biopsy from the techniques of the early 1900s of transperineal open biopsy to the current method of using ultrasound

was paramount in order to initiate treatment and improve prognosis.

Fig. 1. A timeline of the development of the modern prostate biopsy

methods of sampling the prostate gland were used.

guidance to allow transrectal prostate biopsies.

**1. Introduction** 
