A 59-Year-Old Man Comes to the Physician Because of a 3-Month

A 59-year-old man comes to the physician because of a 3-month history of frequent urination. He has to urinate every 1-2 hours during the day and wakes up at least 2-3 times at night to urinate. His pulse is 72/min, and blood pressure is 158/105 mm Hg. Prostate-specific antigen concentration is higher than normal range level and urinalysis shows no abnormalities. Digital rectal examination reveals an indurated prostate with no palpable nodules.  The remainder of the examination is normal.  Prostate biopsy is planned.  Which of the following is the best way to obtain a diagnosis in this patient?

A) Cystoscopy guided; multiple random biopsies of the prostate
B) Cystoscopy guided; single biopsy of the central portion of the prostate
C) Transperineal approach; fine-needle aspiration of the prostate
D) Transrectal route; multiple random biopsies of the prostate
E) Transrectal route; single biopsy from the center of the gland

Correct Answer:

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