Relevance. Nowadays , a high percentage of negative results of the primary biopsy raises, many questions are standing to researchers, one of them is improvement of indications for biopsy.
Objective: To investigate  the results of primary transrectal prostate biopsy, depending on the level of  PSA and mp-MRI of prostate.
Material and methods. Analysed the results of 247 primary multifocal biopsies of the prostate  according to negotiability of patients to RSSPMCU in the period 2016-2019y. Of these, 208 patients underwent a primary biopsy at once, 39 patients after performing a multiparametric MRI of the prostate with an assessment PIRADS-v2 scale 
The average age of patients was 67.34 ± 0.52 (years), the volume of the prostate gland (gland + adenoma) was 73.45 ± 2.17 (cc), while the average level of total PSA in serum was 26.39 ± 0.10 (ng / ml).
The material for the study was taken TRUS guided, tissue took from 10 sites of the prostate gland, with coverage of the peripheral and apical zones. In 39 patients whom performed preoperatively mp-MRI, besides standard 10 shots performed additional 4 to 6 shots from suspicious zone.
Results. Out of 208 primary biopsies, adenocarcinoma was verified in 148 (71.15%) patients, whose prostate volume was 73.98 ± 2.09 (cc), in 60 (28.8%) - BPH, volume 68,62 ± 2,13
Analysis of  morphological study results of the  prostate biopsies, depending on the level of total PSA  showed that with PSA levels of 5-10 ng/ml, 88.8% had a negative result, 5-20 ng/ml had  53.6% , 5-30 ng/ml - 42.5%.
39 patients whom performed mpMRI, PSA level was in 22  5-20 ng/ml, in 11  21-30 ng/ml and in 6   31 ng/ml and above.
In 6 patients with PSA levels above 31 ng/ml, adenocarcinoma was detected (100%); in 11 PSA of 21-30 ng/ml (PIRADS 2, PIRADS 3) - revealed BPH; of 22 patients with PSA levels of 5–20 ng/ml in 1 (4.5%) revealed a neuro-endocrine adenocarcinoma. (with a total PSA level of 5.92 ng/ml, mp-MRI was rated according to the PIRADS 5 scale).
Of 21 (95.0%) patients with a PSA level of 5-30 ng/ml, whom BPH was detected (mean PSA was 17.80 ± 1.40, prostatic volume of 73.8 ± 11.8, according to mpMRI  PIRADS 2 - was in 9, PIRADS 3 - in 12 patients).
Conclusions. PSA level significantly impact on biopsy results. Of the 148 patients who had verified prostatic adenocarcinoma were 61–70 years old and  G3-4 detected in 117(79.3%). Of the 22 patients with a PSA level of 5-30 ng/ml,  (90%) with points on the PIRADS grade (2 and 3) had BPH.

Influence the mpMRI and PSA level on the results of TRUS prostate biopsy