Prostate biopsy strategies: past, present, and future.

Endorectal sonography for prostatic imaging was first described in 1968 and gained wide acceptance, particularly since the 1980s. Presently, extended biopsies consist of the sextant biopsy pattern plus various combinations of anteriorly directed biopsies and posterolateral sampling that includes the anterior horn of the peripheral zone. The cancer detection rate for transrectal ultrasound-guided prostate biopsies has fallen, and the repeat biopsy rate has risen. The future will most likely see fewer biopsies performed but with wiser guiding systems.