A 59-year-old man comes to the physician because of a 3-month history of frequent urination. He has to urinate every 1-2 hours during the day and wakes up at least 2-3 times at night to urinate. His pulse is 72/min, and blood pressure is 158/105 mm Hg. Prostate-specific antigen concentration is higher than normal range level and urinalysis shows no abnormalities. Digital rectal examination reveals an indurated prostate with no palpable nodules. The remainder of the examination is normal. Prostate biopsy is planned. Which of the following is the best way to obtain a diagnosis in this patient?

Question

A 59-year-old man comes to the physician because of a 3-month history of frequent urination. He has to urinate every 1-2 hours during the day and wakes up at least 2-3 times at night to urinate. His pulse is 72/min, and blood pressure is 158/105 mm Hg. Prostate-specific antigen concentration is higher than normal range level and urinalysis shows no abnormalities. Digital rectal examination reveals an indurated prostate with no palpable nodules.  The remainder of the examination is normal.  Prostate biopsy is planned.  Which of the following is the best way to obtain a diagnosis in this patient?

Quizplus · Accepted Answer

Eductional Objective: Most prostate cancer arises in the peripheral zone of the gland, which abuts the rectum.  Therefore, prostate biopsies are primarily obtained via the transrectal approach; multiple random core samples of the prostate are typically taken.  Because only a small part of the peripheral zone encases the distal urethra, patients with prostate cancer do not typically present with urinary symptoms.

A 59-Year-Old Man Comes to the Physician Because of a 3-Month