Objective: To analyze the efficacy of routine transition zone biopsies in patients undergoing ultrasound-guided sextant biopsies for the first time because of a suspicious digital rectal examination (DRE) or an elevated serum prostate-specific antigen (PSA) level.
Patients and methods: During sextant prostatic biopsy two additional transition zone biopsies were performed in 164 consecutive patients: in 98 because of a serum PSA of >4.0 ng/ml, and in 66 because of a suspicious DRE.
Results: The overall cancer detection rate was 46.9% (77/164). In 28 patients (36.4%) cancer was only detected in the peripheral zone, in 2 (2.6%) only in the transition zone and in 47 (61%) in both zones.
Conclusion: Routine transition zone biopsies performed at the time of a first sextant biopsy seem to have low efficacy.