Urol Ann. 2015 Oct-Dec;7(4):428-32. doi: 10.4103/0974-7796.152052.

Significant impact of transperineal template biopsy of the prostate at a single tertiary institution.

Urology annals

Sean Huang, Fairleigh Reeves, Jessica Preece, Prassannah Satasivam, Peter Royce, Jeremy P Grummet

PMID: 26692659 PMCID: PMC4660690 DOI: 10.4103/0974-7796.152052

Abstract

OBJECTIVE: The objective was to review the impact of transperineal biopsy (TPB) at our institution by assessing rates of cancer detection/grading, treatment outcomes and complications.

PATIENTS AND METHODS: A retrospective review of TPBs between 2009 and 2013 was performed. Variables included reason for TPB, age, prostate-specific antigen, previous histology, TPB histology, and management outcomes.

RESULTS: In total, 110 patients underwent 111 TPBs at our institution. On average, 22 cores were taken from each procedure. Disease-upgrade occurred in 37.5% of active surveillance patients, 35% of patients with previous negative transrectal ultrasound, and 58.8% in patients undergoing TPB for other reasons. Of these patients, anterior and/or transition zones were involved in 66%, 79%, and 80%, respectively. Involvement in anterior and/or transition zones only occurred in 40%, 37%, and 10%, respectively. About 77% of patients with disease-upgrading underwent treatment with curative intent. Complications included a 6.3% rate of acute urinary retention and 2.7% of clot retention, with no episodes of urosepsis.

CONCLUSIONS: Transperineal biopsy at our institution showed a high rate of disease-upgrading, with a large proportion involving anterior and transition zones. A significant amount of patients went on to receive curative treatment. TPB is a valuable diagnostic procedure with minimal risk of developing urosepsis. We believe TBP should be offered as an option for all repeat prostate biopsies and considered as an option for initial prostate biopsy.

Keywords: Biopsy; complications; prostate; prostatic neoplasms; sepsis; transperineal

References

1. Cancer. 2000 Oct 15;89(8):1800-9 - PubMed
2. Urol Int. 2010;84(4):395-9 - PubMed
3. BJU Int. 2014 Sep;114(3):384-8 - PubMed
4. Eur Urol. 2014 Sep;66(3):406-13 - PubMed
5. BJU Int. 2010 May;105(9):1231-6 - PubMed
6. Urology. 2003 Dec;62(6):1050-3 - PubMed
7. Urology. 2005 Jul;66(1):114-8 - PubMed
8. BJU Int. 2012 Apr;109 (8):1170-6 - PubMed
9. Asian J Androl. 2012 Mar;14(2):310-5 - PubMed
10. Med J Aust. 2013 Mar 18;198(5):267-9 - PubMed
11. Urology. 2009 Feb;73(2):386-8 - PubMed
12. Curr Opin Urol. 2009 May;19(3):232-7 - PubMed
13. Urology. 2013 Jun;81(6):1142-6 - PubMed
14. BJU Int. 2013 May;111(6):946-53 - PubMed
15. Int J Urol. 2009 Dec;16(12):930-5 - PubMed
16. Prostate. 2004 Jan 1;58(1):76-81 - PubMed
17. ANZ J Surg. 2005 Jan-Feb;75(1-2):48-50 - PubMed
18. BJU Int. 2012 Jun;109(12):1781-5 - PubMed
19. Eur Urol. 2013 Apr;63(4):597-603 - PubMed
20. J Hosp Infect. 2013 Aug;84(4):300-4 - PubMed
21. Urol Oncol. 2013 Oct;31(7):1093-7 - PubMed
22. BJU Int. 2012 Oct;110(7):993-7 - PubMed
23. Urology. 2011 Apr;77(4):921-5 - PubMed
24. J Urol. 1998 Apr;159(4):1247-50 - PubMed
25. Clin Infect Dis. 2013 Jul;57(2):267-74 - PubMed
26. Int J Urol. 2004 Aug;11(8):613-8 - PubMed
27. BJU Int. 2013 Sep;112(5):585-93 - PubMed

Publication Types

• Journal Article