How Much Digital Rectal Examination is Valuable for the Decision of Biopsy in Patients with PSA ≤4 ng/ml?

Summary Objective: In this study we aimed to investigate the importance of digital rectal examination (DRE) for the decision of prostat biopsy with transrectal ultrasound (TRUS) in patients with Prostate specific antigen (PSA) ≤4 ng/ ml. Materials and Methods: We retrospectively evaluated the data of 287 patients who underwent prostat biopsy with TRUS between 2009 and 2014 and had DRE findings recorded and PSA value ≤4 ng/ml. PSA values, DRE findings, biopsy results and gleason grades were noted. Results: Mean age of the patients was 61.8 (38-85) years. Mean PSA value was 3.1 (0.17-4.0) ng/ml. DRE findings were noted as induration, nodularity, irregularity and stiffness. Prostate cancer was detected 78 (27%) in patients with positive DRE findings according to prostate biopsy results. Of the patients with prostate cancer 32 underwent radical prostatectomy in our clinic. Mean biopsy gleason score was 6.23±1.2 mean radical prostatectomy gleason score was 6.1±0.67. Conclusion: DRE is an important parameter and guides clinicians in the decision of biopsy and management of patients with PSA ≤4 ng/ml.