Rebiopsy rate after transperineal or transrectal prostate biopsy

Abstract

Background In recent years, transperineal biopsies gained popularity for prostate cancer diagnosis; lower infective complications and improved sampling of the prostate are the main advantages of this technique. One question that remains unclear is whether an initial transperineal biopsy confers a lower risk for rebiopsy compared with the transrectal approach. Methods Six hundred seventy-one men were prospectively followed after an initial negative prostate biopsy for a median period of 49.50 (IQR: 37.62–61.17) months. Rebiopsy rate was analyzed attending to first biopsy approach (transrectal versus transperineal systematic) and clinical variables. Results Diagnostic rate was similar for transrectal and transperineal systematic biopsies. Targeted biopsies outperformed any systematic approach, and transperineal targeted in particular was superior to transrectal targeted. Rebiopsy rates were 15.4% and 5.26% for the transrectal and transperineal systematic groups, respectively. Prostate-specific antigen density and type of first biopsy were identified as rebiopsy predictors. Conclusion Men undergoing transperineal systematic biopsies had a three times lower rate of rebiopsy over the study period compared with the traditional transrectal approach. This advantage could be added to the already described potential benefits of transperineal biopsies. Targeted biopsies had lower rebiopsy rate over the study period. Further innovations that decreased the cost of transperineal biopsies could favor this approach in the future.

Is antibiotic prophylaxis still mandatory for transperineal prostate biopsy? Results of a comparative study

“…The principal advantages over the TRs are reported as reduced bacterial contamination with the consequent reduction in UTIs and better access for the sampling of the anterior zone. Moreover, a recent paper by Marenco Jimenez et al 23 reported a significantly lower rebiopsy rate after TP-PB compared to TR ones.…”

Avoiding Prostate Biopsies in Patients at Low Risk for Prostate Cancer: A Prospective Evaluation of a PSA-Density-Based Safety Net

“…At our institution, transperineal PBx was established after the conclusion of this study. There are data suggesting a higher tumor detection rate by targeted transperineal PBx and in patients undergoing repeated PBx [24]. However, tumor detection rates in systematic biopsies are comparable when performing transrectal or transperineal PBx [24].…”

“…There are data suggesting a higher tumor detection rate by targeted transperineal PBx and in patients undergoing repeated PBx [24]. However, tumor detection rates in systematic biopsies are comparable when performing transrectal or transperineal PBx [24]. Thus, the probability of missing both PCa and csPCa after new mpMRI revealed no high-grade PIRADS lesions appears to be minimal.…”

Three-dimensional ultrasound integrating nomogram and the blood flow image for prostate cancer diagnosis and biopsy: A retrospective study

“…Preoperative prophylactic use of antibiotics can better control the incidence of postoperative infection complications. In this study, diabetic patients suffered from postoperative infection complications due to preoperative prophylactic use of antibiotics.Study reported ( 30 ) that the re-biopsy rate of patients with traditional transrectal prostate biopsy was three times higher than that of transperineal prostate system biopsy (15.4% Vs 5.26%), and targeted biopsy could further reduce the re-biopsy rate. In this study, the re biopsy rates of patients in the 3D-TRUS group and TRUS group were 1.33% and 2.39%, slightly lower than the previous study results.…”