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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2019; 28(02): 130-141
DOI: 10.1055/s-0038-1661364
Review Articles | Artículos de Revisión
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Biopsia transrectal ecodirigida de la próstata: estado del arte y guía práctica de consejos y trucos

Transrectal Ultrasound Biopsy of the Prostate: State of the Art and Practical Guide of Tip and Tricks
Julián Chavarriaga Soto
1   Residente de Urología, Pontificia Universidad Javeriana, Bogotá, Colombia
,
María Antonia Ocampo
2   Estudiante de Medicina, Universidad del Rosario, Bogotá, Colombia
,
Andrés Felipe Gutiérrez
3   Departamento de Urología, Hospital Universitario San Ignacio, Profesor Ad Honorem Pontificia Universidad Javeriana, Bogotá, Colombia
› Author Affiliations
Further Information

Publication History

21 March 2018

25 May 2018

Publication Date:
25 June 2018 (online)

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Resumen

Introducción y Objetivos La biopsia transrectal de la próstata (BTRP), fue propuesta por primera vez en 1937 y hasta 1981 se realizó la primera biopsia ecodirigida, actualmente es la vía de acceso a la próstata más utilizada por su fácil curva de aprendizaje como por el alto rendimiento diagnóstico, sin embargo, en el Reino Unido, el 68% de los urólogos no realizan BTRP porque consideran que no han recibido suficiente entrenamiento. El objetivo de este estudio es describir las diferentes técnicas utilizadas en la actualidad, las complicaciones del procedimiento y aportar una guía de consejos y trucos implementada en varios centros de referencia a la hora de realizar una BTRP para prevenir complicaciones, mejorar el desempeño de la prueba y del urólogo y estandarizar el método de toma de la BTRP.

Materiales y Métodos Realizamos una búsqueda en las bases de datos de PubMed, MEDLINE, SciELO utilizando las palabras claves “Transrectal ultrasound biopsy of the prostate” “tips and tricks” “Transperineal biopsy of the prostate” “Magnetic resonance imaging targeted biopsy” “MRI/US fusion biopsy”, basados en la literatura y en la experiencia de los autores de más de 1100 biopsias anuales entre los diferentes centros de referencia. Brindamos una guía práctica de consejos y trucos para facilitar el desempeño del urólogo en la BTRP.

Resultados La biopsia transrectal de próstata ecodirigida continúa siendo la primera opción para el abordaje diagnóstico del paciente con sospecha clínica de cáncer de próstata, es de gran importancia estandarizar el esquema de toma de la biopsia, y en nuestro caso recomendamos utilizar un esquema de 12 cores, definir la profilaxis antibióticas y la duración del tratamiento, y el uso de analgesia o anestesia local. Presentamos los consejos y trucos que hemos utilizado en nuestra práctica clínica en varios centros de referencia.

Abstract

Introduction Transrectal biopsy of the prostate was described for the first time in 1937, and it was not until 1981 the first transrectal biopsy of the prostate was done using transrectal ultrasound to guide the procedure. Nowadays it is the most popular technique to obtain prostatic tissue when suspecting adenocarcinoma of the prostate, this due to its easy learning curve and to its excellent diagnostic performance. Up to 68% of urologist in the UK do not do prostate biopsy arguing they have not received enough training The aim of this article is to describe the different techniques, the physics of ultrasonography and a practical guide of tips and tricks from a center where we performed up to 1100 transrectal ultrasound biopsies annually, aiming to improve the diagnostic performance and lower the complicacion rates of the biopsy.

Methods We performed a search in PubMed, MEDLINE, SciELO using the keywords “Transrectal ultrasound biopsy of the prostate” “tips and tricks” “Transperineal biopsy of the prostate””Magnetic resonance imaging targeted biopsy” “MRI/US fusion biopsy,” and base on the literature review and our experience of more than a thousand biopsies annually we wrote this article.

Results TRUS biopsy of the prostate continue to be the first choice in the urologist armamentarium to diagnose the patient with clinical suspicion of prostate cáncer, with a low complication rate, a good diagnostic performance and an easy learning curve. It is necessary to standardized the procedure, perform a doble sextant biopsy, define the best antibiotic prophylaxis, the technique for anesthesia/analgesia. Here we present our practical guide of tips and tricks.

Palabras Clave

cáncer de próstata - próstata - aspiración por aguja fina ecodirigida - ecografía - biopsia

Keywords

cancer of the prostate - prostate - endoscopic ultrasound guided fine needle aspiration - ultrasound - biopsy
 

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