Objective: Sextant ultrasound-guided biopsy is still the standard way for the diagnosis of prostate cancer, although there have been several modifications. We report our experience using a 7.5 MHz endovaginal "end-fire" probe in patients undergoing prostate biopsy because of clinical findings suggestive of prostate cancer (abnormal digital rectal examination and/or elevated prostate specific antigen).
Materials and methods: Since June 1999 to December 2001, we performed 262 ultrasound-guided transrectal 18G core biopsies with a 7.5 MHz endovaginal "end-fire" probe, using different schemes according to the presence or not of suspicious areas on ultrasound (a modified sextant biopsies plus two cores from the transitional zone with multiple cores from and around suspected lesions in case of abnormal findings on ultrasound).
Results: We obtained a detection rate of about 44%. Complications were mild: 5 cases (1.9%) of urosepsis and 4 cases (1.5%) of urinary retention. Both haematuria and rectal bleeding were not significant.
Conclusions: The endovaginal "end-fire" probe allows us to obtain core biopsies in both longitudinal and transverse view. This means an optimal sampling of the prostate gland, in particular a better and safer sampling of transitional zone avoiding the prostatic urethra and the choice of the best plane in order to sample more peripheral zone and its lateral aspects. Furthermore, with the "end-fire" probe it is quite simple to obtain cores biopsies from every portion of the prostate gland and, consequently, it is possible to make an accurate staging of the disease prior to surgery.