Ultrasound guided seminal vesicle biopsies in men with suspected prostate cancer

Abstract

Purpose: The histology of ultrasound guided seminal vesicle biopsies is assessed and the results are correlated with clinical or pathological stage of prostate cancer.

Materials and methods: A total of 517 consecutive men underwent bilateral (515) or unilateral (2) seminal vesicle biopsy during sextant biopsy of the prostate.

Results: Seminal vesicle epithelium and muscularis were identified in 490 of 1,032 biopsy specimens (47%) and smooth muscle consistent with seminal vesicle muscularis was identified in 393 (38%). The seminal vesicle biopsy was positive for cancer in 7 of 123 patients (6%) with with clinical stages T1c and T2 tumors, 27 of 60 (45%) with stages T3 to 4 disease and 9 of 13 (69%) with metastatic cancer. Of 39 patients who underwent radical prostatectomy 1 of 36 (3%) without and 0 of 3 (0%) with seminal vesicle invasion had a positive seminal vesicle biopsy.

Conclusions: Seminal vesicle epithelium and muscularis or smooth muscle consistent with the seminal vesicle muscularis can be procured in most patients using contemporary ultrasound guided biopsy techniques. However, apparently false-negative seminal vesicle biopsies are not uncommon and seminal vesicle biopsies contribute little to the staging of T1c and T2 tumors.