Biopsy of the prostate - the urge to search for a new standard

Although the worldwide urological community generally accepts the existing protocol of TRUS-guided (transrectal ultrasound-guided) random prostate biopsy, there is strong evidence that sextant, extended, and saturation protocols are not sufficiently accurate (with ranges from 28-78%). Moreover, the number of repeated biopsies remains extremely high (33%) as a consequence of using an imperfect diagnostic tool. An overview of current literature concerning common practice in prostatic biopsies has revealed discrepancies in indications, technique, number of cores collected, and pathological examination standards. This fact has prompted many authors to search for methods of improving the existing standard. The latest developments in the field are primarily related to MRI-guided (magnetic resonance-guided) targeted prostate biopsy, which is currently a promising tool in diagnosing prostate cancer. However, genetically supported molecular biopsy seems to be a highly promising avenue for developing the future biopsy standard.