Sawazaki Harutake, Kitamura Yosuke, Asano Atsushi, Suzuki Sadayoshi
Department of Urology, Tama-Hokubu Medical Center, Higashimurayama, Japan.
Department of Urology, National Defense Medical College, Tokorozawa, Japan.
Res Rep Urol. 2025 Apr 23;17:119-127. doi: 10.2147/RRU.S523114. eCollection 2025.
A standard prostate biopsy can be performed via a transrectal or transperineal approach using a transrectal ultrasound probe, but not in patients without a rectum. These patients pose a diagnostic challenge to urologists in terms of prostate cancer detection. We report use of a novel technique for cognitive magnetic resonance imaging (MRI)-transperineal ultrasound fusion prostate biopsy with a urinary catheter in two patients without a rectum after abdominoperineal resection. In both cases, a urinary catheter was inserted and clamped after injection of 250 mL of sterile saline into the bladder to improve visualization of the prostate. The inflated catheter balloon was placed to the level of the bladder neck to identify the base of the prostate. Cognitive MRI-transperineal ultrasound fusion biopsy was performed on the MRI-defined lesions after confirmation of anatomic landmarks, including the urethra and base of the prostate. Systemic 8-core biopsies were also obtained. In both patients, the targeted lesion was diagnosed as prostate cancer.
标准的前列腺活检可通过经直肠或经会阴途径，使用经直肠超声探头进行，但不适用于没有直肠的患者。这些患者在前列腺癌检测方面给泌尿外科医生带来了诊断挑战。我们报告了一种新技术，即在两名经腹会阴切除术后没有直肠的患者中，使用认知磁共振成像（MRI）-经会阴超声融合技术，并结合导尿管进行前列腺活检。在这两个病例中，向膀胱内注入250毫升无菌生理盐水后插入导尿管并夹紧，以改善前列腺的可视化。将膨胀的导尿管球囊放置在膀胱颈水平以确定前列腺底部。在确认包括尿道和前列腺底部在内的解剖标志后，对MRI定义的病变进行认知MRI-经会阴超声融合活检。同时也进行了系统性的8针活检。两名患者的靶向病变均被诊断为前列腺癌。
