Shifting to transperineal prostate biopsy: A narrative review

Chung, Younsoo; Hong, Sung Kyu

doi:10.1016/j.prnil.2023.11.003

Cited by 9 publications

(2 citation statements)

References 69 publications

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“…However, the TR approach is inadequate for accessing the apical and anterior regions of the prostate. Consequently, the transperineal (TP) biopsy has emerged as an alternative to overcome the limitations of the TR biopsy [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Infection Following Local Anesthetic Transperineal Prostate Biopsy: A Single-Centre Experience

Khalabazyane,

Mizzi,

Rashid

et al. 2024

Cureus

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BackgroundLocal anesthetic transperineal prostate biopsy (LATP) is a widely used diagnostic procedure for prostate cancer. As a diagnostic procedure, it should carry minimal risk. However, morbidity resulting from prostate biopsy is frequent. Prostate biopsy, like any other intervention, carries a significant risk of various infections, ranging from urinary tract infections (UTIs) to potentially life-threatening conditions like sepsis. AimThis study examined the rate of infections following a prostate biopsy at a single center and sought to identify risk factors that could increase the likelihood of developing an infection. MethodsA retrospective review was conducted on all 168 patients who underwent LATP biopsy between 01/04/2022 and 01/04/2023. Data were collected from the Clinical Record and Reporting System (CRRS). Patient characteristics, including age, prostate-specific antigen (PSA) levels, prostate volume, the main indication for the biopsy, number of cores taken, antibiotic prophylaxis, and comorbidities were analyzed. The inclusion criteria encompassed all patients receiving this procedure within the specified timeframe, without restrictions on age, underlying health conditions, or medical history. No exclusion criteria were applied, aiming to comprehensively analyze and capture the full spectrum of patient outcomes and characteristics associated with these biopsies during the study period. ResultsIn terms of socio-demographics, all patients were male with an average age (mean) of 65.5 years, a mean PSA level of 13.9 ng/dL, and an average prostate volume of 66.1 mL. On average, 23.2 biopsy cores were taken. All patients received antibiotic prophylaxis, mainly ciprofloxacin. Despite this, 1.78% of patients (n=3) developed post-biopsy infections. Two of these patients had diabetes mellitus, and two had a large prostate volume of 95 mL.

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Section: Discussionmentioning

confidence: 99%

Incidence of Infection Following Local Anesthetic Transperineal Prostate Biopsy: A Single-Centre Experience

Khalabazyane,

Mizzi,

Rashid

et al. 2024

Cureus

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“…The TR approach has historically been advantageous in terms of cost and time but disadvantaged by increased risk of sepsis up to 7%. The TP approach offers reduced risk of infection, as well as improved anterior and apical sampling, but is limited by the requirement of general anesthesia [67]. The introduction of the freehand technique (e.g., PrecisionPoint Transperineal Access System, Perineologic) paired with effective local anesthesia has decreased the procedural time allowed for office-based practice, thus rapidly increasing adaptation of the TP approach [68,69].…”

Section: Tp Vs Tr Approachmentioning

confidence: 99%

MRI–Ultrasound Fused Approach for Prostate Biopsy—How It Is Performed

Lang,

McClure,

Margolis

2024

Cancers

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The use of MRI–ultrasound image fusion targeted biopsy of the prostate in the face of an elevated serum PSA is now recommended by multiple societies, and results in improved detection of clinically significant cancer and, potentially, decreased detection of indolent disease. This combines the excellent sensitivity of MRI for clinically significant prostate cancer and the real-time biopsy guidance and confirmation of ultrasound. Both transperineal and transrectal approaches can be implemented using cognitive fusion, mechanical fusion with an articulated arm and electromagnetic registration, or pure software registration. The performance has been shown comparable to in-bore MRI biopsy performance. However, a number of factors influence the performance of this technique, including the quality and interpretation of the MRI, the approach used for biopsy, and experience of the practitioner, with most studies showing comparable performance of MRI–ultrasound fusion to in-bore targeted biopsy. Future improvements including artificial intelligence promise to refine the performance of all approaches.

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Safety and Efficacy of Intra‐Prostatic Injection of Betamethasone for Refractory Chronic Nonbacterial Prostatitis: A Prospective Cohort Clinical Study

Abdelaziz,

Kishk,

Meshref

et al. 2024

The Prostate

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BackgroundWe aimed to assess the safety and effectiveness of TRUS guided betamethasone injections in refractory cases of chronic nonbacterial prostatitis.Patients and MethodsForty‐five patients with refractory CNP were included in a prospective cohort clinical trial. Six injections of betamethasone sodium sulfate were guided by TRUS. After injection: assessment of NIH‐CPSI, IPSS, IIEF, GRA and VAS were performed 1, 4, and 12 weeks after injection. Prostatitis symptoms were measured by NIH‐CPSI. We considered the minimal clinically important difference (MCID) as a 25% decrease or a six‐point reduction from baseline. We considered the MCID of the IIEF to be at least an increase of 4 points. We considered the MCID of the IPSS score to be three points and the MCID for the VAS score to be a 25%–35% change of the initial score. Regarding the global response assessment (GRA), scores 5–7 means significant success rate of perceived treatment.ResultsAccording to total NIH CPSI score, the success rate of injected cases was 71% after 1 week, dropping to 55.6% after 4 weeks and 44.4% after 12 weeks. According to IPSS questionnaire, the MD (mean difference) is −4.09 ± 3.5, −3.8 ± 3.83 and −3.47 ± 3.92. According to the IIEF questionnaire, the success rate was 22% and 26.7% after 4 and 12 weeks respectively. According to GRA, successful pain control was reported in 82%, 71% and 64.4% after 1, 4 and 12 weeks, respectively.ConclusionIntraprostatic betamethasone injection is a simple, safe, and feasible procedure in refractory cases with CNP with predominant pain and urinary symptoms.

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Shifting to transperineal prostate biopsy: A narrative review

Cited by 9 publications

References 69 publications

Incidence of Infection Following Local Anesthetic Transperineal Prostate Biopsy: A Single-Centre Experience

Incidence of Infection Following Local Anesthetic Transperineal Prostate Biopsy: A Single-Centre Experience

MRI–Ultrasound Fused Approach for Prostate Biopsy—How It Is Performed

Safety and Efficacy of Intra‐Prostatic Injection of Betamethasone for Refractory Chronic Nonbacterial Prostatitis: A Prospective Cohort Clinical Study

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