Retrospective analysis of 645 simultaneous perineal punch biopsies and transrectal aspiration biopsies for diagnosis of prostatic carcinoma.

Transrectal aspiration biopsy of the prostate has been recommended as method of choice for morphological diagnosis of prostatic malignancies. It is less inconvenient to the patient and with hardly any complications. A retrospective analysis of 645 simultaneous perineal punch biopsies and transrectal aspiration biopsies was carried out in order to elicit whether prostatic carcinoma can be detected with transrectal aspiration biopsy as frequently as with perineal punch biopsy, and whether a cytological diagnosis of prostatic cancer is reliable. Carcinoma of the prostate was found in a total of 39.1% either with both techniques or with only one of them. A concordant diagnosis has been obtained in only 25.1%. Prostatic carcinoma was diagnosed more often by perineal punch biopsy (36.1%) than by transrectal aspiration biopsy (27.7%). However, the diagnosis has been missed by perineal punch biopsy in 2.6% of the cases. Doubtful results and unsatisfactory preparations have been observed more frequently after transrectal aspiration biopsies. Definite 'false-positive' cystological findings have not been detected. Thus, cytological evaluation of aspirated prostatic cells appears reliable. A definite morphological diagnosis can be expected with this technique. Simultaneous application of perineal punch biopsy and transrectal aspiration biopsy can be recommended in order to diagnose prostatic carcinoma with a higher frequency.