Outcomes of transperineal and transrectal ultrasound-guided prostate biopsy

Lo, Ka Lun; Chui, Ka Lung; Leung, S. F.; D.M.F., Salvadori; Lim, Kevin; Ng, Tze Kiat; Wong, Janet Yuen‐Ha; Li, J K M; Mak, Sum; Ng, CF

doi:10.12809/hkmj187599

Cited by 16 publications

(25 citation statements)

References 13 publications

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“…We found 39 retrospective studies, 46 prospective studies, and 13 RCTs where periprocedural antibiotics were administered [12] , [13] , [14] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [67] , [68] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , …”

Section: Evidence Synthesisunclassified

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Basourakos

Alshak

Lewicki

et al. 2022

European Urology Open Science

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Section: Evidence Synthesisunclassified

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Basourakos

Alshak

Lewicki

et al. 2022

European Urology Open Science

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“…As per the results of our analysis, the rate of rectal bleeding demonstrated a remarkable heterogeneity, ranging from 0% to 37.1% ( Table 1 ). 13 - 39 Notably, the clear stratification between mild, moderate, and severe bleeding in individual studies was not clearly delineated. However, most patients experienced minor bleeding episodes that were amenable to traditional conservative measures.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Therapy in the Management of Patients With Severe Rectal Bleeding Following Transrectal Ultrasound-Guided Prostate Biopsy: A Case-Based Systematic Review

Malik

Ishtiaq

Goraya

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Rectal bleeding is a known complication of transrectal ultrasound-guided prostate biopsy. It is usually mild and resolves spontaneously. However, massive life-threatening hemorrhage can also rarely occur in this setting, potentially presenting a therapeutic conundrum. We hereby delineate the case of a patient who experienced severe intermittent lower gastrointestinal bleeding following a transrectal ultrasound-guided prostate biopsy. Traditional tamponade methods failed to control the hemorrhage. Subsequently, an urgent flexible sigmoidoscopy revealed an anterior rectal wall prominence with biopsy punctures as the possible source of bleeding. Endoclip was successfully applied at the bleeding site, achieving permanent hemostasis. The patient had an uneventful recovery and was discharged from the hospital. While the use of endoclipping has been widely reported in gastrointestinal endoscopy, its application remains exceedingly rare in this group of patients. To our knowledge, this case represents only the third report of endoclipping alone to treat massive rectal bleeding follwing a prostate biopsy procedure. In addition, we systematically review published medical literature to evaluate endoscopic techniques aimed at managing this important complication. This article illustrates that endoscopic therapy may present an efficient, noninvasive method to deal with severe post-biopsy rectal hemorrhage. Therefore, prompt consultation with the gastroenterology service should be advocated.

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“…The transperineal approach is a percutaneous technique for prostate biopsy needle passage that avoids translocating rectal bacteria into the sterile urinary tract altogether. The rate of cancer detection with transperineal biopsy is similar to transrectal biopsy 3–6. Systematic reviews of transperineal biopsy under general and local anesthesia also demonstrate lower rates of infectious complication, with reported rates of urinary tract infection and sepsis as low as 0%–1.6% and 0% 7 8.…”

Section: Introductionmentioning

confidence: 87%

IDEAL Stage 2a experience with in-office, transperineal MRI/ultrasound software fusion targeted prostate biopsy

Tzeng

Cricco-Lizza

Pantuck

et al. 2019

BMJ Surg Interv Health Technologies

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ObjectiveAlthough the feasibility of transperineal biopsy under local anesthesia has been demonstrated, little is known regarding the application of MRI/ultrasound software fusion targeted biopsy for transperineal biopsy under local anesthesia. The objective of our study is to describe our initial experience with in-office transperineal MRI/ultrasound software fusion targeted biopsy (Idea, Development, Exploration, Assessment, Long-term Follow-up [IDEAL] Stage 2a).MethodsBetween October 2017 and July 2019, 33 men underwent in-office transperineal MRI-targeted biopsy using the Artemis (Eigen, Grass Valley, CA, USA) fixed-robotic arm system. The indication for biopsy was elevated prostate specific antigen (PSA) (n=14), prior negative biopsy (n=10), active surveillance (n=6), and surveillance after partial gland cryoablation (n=3). We prospectively captured patient demographic and clinical characteristics, biopsy outcomes, and complications. Complications were classified according to Common Terminology Criteria for Adverse Events (CTCAE) V.5.0.ResultsThe median patient age was 67 years (IQR 61–71) and the median serum PSA level was 7.0 ng/mL (IQR 5.1–11.4). The median duration of in-office MRI-targeted transperineal biopsy was 26 min (IQR 23–28). Overall, transperineal MRI-targeted biopsy detected prostate cancer in 18 (54.6%) men, with 8 (24.2%) being clinically significant (Gleason Score ≥3+4, Grade Group ≥2). Clinically significant prostate cancer was detected in four (28.6%) biopsy naïve men, two (20.0%) men with a prior negative, one (16.7%) man on active surveillance and one (33.3%) man following partial gland ablation. Three (9.1%) men experienced complications: two hematuria and one urinary retention.ConclusionOur findings demonstrate the feasibility of the fixed-robotic arm fusion platform for in-office transperineal MRI-targeted biopsy and a low rate of adverse events. However, larger prostate size precludes MRI/ultrasound software fusion and pubic arch interference hindered the transperineal MRI-targeted approach in 9.1% of men. Pubic arch interference was overcome by a free-hand approach with software fusion guidance.

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Outcomes of transperineal and transrectal ultrasound-guided prostate biopsy

Cited by 16 publications

References 13 publications

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Endoscopic Therapy in the Management of Patients With Severe Rectal Bleeding Following Transrectal Ultrasound-Guided Prostate Biopsy: A Case-Based Systematic Review

IDEAL Stage 2a experience with in-office, transperineal MRI/ultrasound software fusion targeted prostate biopsy

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