353 as Part of an Active Surveillance Protocol Transperineal Saturation Prostate Biopies Do Not Compromise Radical Prostatectomy

Kinsella, Netty; Vyas, Lona; Challacombe, Ben; Popert, Rick; Hemelrijck, Mieke Van; Cahill, Declan

doi:10.1016/j.juro.2012.02.415

Cited by 2 publications

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“…Analysis of robot-assisted laparoscopic radical prostatectomy specimens after transperineal biopsy has shown evidence of previous sampling in the form of iron-laden macrophages and pockets of inflammation. With longer duration between biopsy and surgery, some fibrosis would be inevitable; however, we have not experienced any specific increased anastomotic complications or increased positive apical margins [20].…”

Section: Prostate Volume MLmentioning

confidence: 78%

Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases

et al. 2014

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Objective• To describe a protocol for transperineal sector biopsies (TPSB) of the prostate and present the clinical experience of this technique in a UK population. Patients and Methods• A retrospective review of a single-centre experience of TPSB approach was undertaken that preferentially, but not exclusively, targeted the peripheral zone of the prostate with 24-38 cores using a 'sector plan' . Procedures were carried out under general anaesthetic in most patients.• Between January 2007 and August 2011, 634 consecutive patients underwent TPSB for the following indications: prior negative transrectal biopsy (TRB; 174 men); primary biopsy in men at risk of sepsis (153); further evaluation after low-risk disease diagnosed based on a 12-core TRB (307). Results• Prostate cancer was found in 36% of men after a negative TRB; 17% of these had disease solely in anterior sectors.• As a primary diagnostic strategy, prostate cancer was diagnosed in 54% of men (median PSA level was 7.4 ng/mL).• Of men with Gleason 3+3 disease on TRB, 29%were upgraded and went on to have radical treatment.• Postoperative urinary retention occurred in 11 (1.7%) men, two secondary to clots. Per-urethral bleeding requiring hospital stay occurred in two men. There were no cases of urosepsis. Conclusions• TPSB of the prostate has a role in defining disease previously missed or under-diagnosed by TRB. The procedure has low morbidity.

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Section: Prostate Volume MLmentioning

confidence: 78%

Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases

et al. 2014

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“…TP biopsy is not associated with a greater risk of erectile dysfunction and its effect on dissection in RP appears to be anecdotal only .…”

Section: Discussionmentioning

confidence: 95%

Sepsis and ‘superbugs’: should we favour the transperineal over the transrectal approach for prostate biopsy?

et al. 2014

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Objective• To determine the rate of hospital re-admission for sepsis after transperineal (TP) biopsy using both local data and worldwide literature, as there is growing interest in TP biopsy as an alternative to transrectal ultrasonography (TRUS)-guided biopsy for patients undergoing repeat prostate biopsy. Patients and Methods• Pooled prospective databases on TP biopsy from multiple centres in Melbourne were queried for rates of re-admission for infection.• A literature review of PubMed and Embase was also conducted using the search terms: 'prostate biopsy, fever, infection, sepsis, septicaemia and complications' . Results• In all, 245 TP biopsies were performed (111 at Alfred Health, 92 at Epworth Healthcare, 38 at Peter MacCallum Cancer Centre, and four at other institutions).• The rate of hospital re-admission for infection was zero.• The literature review showed that the rate of sepsis after TRUS biopsy appears to be rising with increasing rates of multi-resistant bacteria found in rectal flora, and is as high as 5%.• However, the rate of sepsis from published series of TP biopsy approached zero. Conclusions• Both local and international data suggest a negligible rate of sepsis with TP biopsy.• This compares to a concerning rise in the rate of sepsis after TRUS biopsy due to the increasing prevalence of multi-resistant bacteria in rectal flora.• Although TRUS biopsy is convenient, cheap and quick to perform, we think that TP biopsy should now be offered as an option, not only to patients undergoing repeat prostate biopsy, but to all patients in whom a prostate biopsy is indicated.

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353 as Part of an Active Surveillance Protocol Transperineal Saturation Prostate Biopies Do Not Compromise Radical Prostatectomy

Cited by 2 publications

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Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases

Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases

Sepsis and ‘superbugs’: should we favour the transperineal over the transrectal approach for prostate biopsy?

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