Conclusions

Evaluation of the prostate in men with an elevated PSA who have undergone APR is challenging due to inability to perform DRE and TRUS-guided prostate biopsy. TPUS-guided prostate biopsy is the most cost effective and feasible modality for diagnosing prostate cancer in these patients. However, given that men aged 50-75 are at increased risk for both prostate cancer and colorectal cancer, preoperative prostate cancer screening in men who are planning APR allows for proper assessment of the prostate before access to the rectum is compromised, provides a baseline PSA to compare with further testing after the APR, and may detect synchronous malignancies. A multidisciplinary approach is ideal when considering prostate cancer screening in men 50 years of age or older with reasonable life expectancy who are planning APR.

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