A 57-year old man was found on routine screening to have a serum prostate specific antigen (PSA) level of 4.1 ng/mL, and was referred for evaluation. He had bilateral induration at the base of the prostate. A transrectal ultrasonography and prostate needle biopsy were performed based on the elevated PSA. The ultrasonography revealed no abnormalities, but 3 of 10 core biopsies obtained under ultrasonographic guidance revealed prostatic adenocarcinoma. There were 2 positive biopsies on the left and 1 on the right; the Gleason score in each core was 3 + 3. The patient had a history of laparoscopic bilateral hernia repair with the use of mesh approximately 6 months before his referral. His past medical history was otherwise significant only for hypertension.
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Accepted: October 17, 2003San Francisco, Calif
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.