Patient-Reported Experience of Modified Transperineal Template Guided Saturation Biopsy Under General Anaesthesia and without Prophylactic Catheterisation

Abstract

Results of patient feedback questionnaire following transperineal template guided saturation biopsy (TPSB) without prophylactic catheterisation. Introduction and Objective: TPSB is increasingly utilised in the diagnosis and characterisation of prostate cancer. However, there is little data on patient experience after undergoing this procedure. We circulated a questionnaire to 511 consecutive patients from July 2007 to December 2014 and now analyse the responses. Materials and Methods: The mean age for the cohort was 64 (range 43-82). A mean of 28 biopsy cores (range 13-43) were taken under general anaesthesia (GA), as day case procedure. Patients received diclofenac 100 mg suppository on completion of the procedure. The questionnaire explored symptoms at 1 h, 1, 3 and 7 days postoperatively. Results: There were 301 responses (59%). Following TPSB, 38% initially experienced rectal bleeding, falling significantly to 3% on day 7 (p < 0.001) and it was not a serious condition in all cases. A majority reported haematuria at 1 h but persisting at 1 week in over one quarter (p < 0.001). Nevertheless, although initially often dark, none had other than pale pink by the end of the reporting period. In contrast, the incidence of haematospermia increased over 7 days, rising significantly to 38% by this stage (p < 0.001). Several patients commented that the procedure was more tolerable than their previous conventional TRUS biopsy and 20 (6.6%) with voiding difficulty required catheterisation. In all, 23% patients felt pain, and out of these 23% only 5% required minor analgesia at day 7. Conclusion: TPSB under GA without prophylactic catheterisation is well tolerated, carrying acceptable postoperative symptom rates. Interestingly, a significant proportion of patients ejaculate within 7 days, which again suggests good tolerance to the procedure. Patients should be provided with this data preoperatively when they are considering TPSB.

TOP: Prospective Evaluation of a Volume Based, Computer Assisted Method for Transperineal Optimized Prostate Biopsy

“…Moreover, they are well tolerated and have only minor, temporarily side effects like hematuria, short-term catheterization, erectile deterioration, or fever with no septic complications being reported [32] . Thus, patients seem to handle them at least as good as conventional TRUS biopsy [33] . Our data support the hypothesis that next to MRI-invisible tumors one main reason for negative TB are targeting errors [34] .…”

Active Surveillance Following Modified Transperineal Template Guided Saturation Biopsy Demonstrates a Low Rate of Progression and Conversion to Radical Treatment, with Age and PSA Associated with Upgrading, Upstaging and Treatment

“…Patient reported experience also demonstrates that the procedure is well tolerated and caries acceptable postoperative symptom rates [17]. Briefly, all procedures were performed under GA, with a side viewing, biplanar implant probe (BK Medical, Herlev, Denmark) attached to a brachytherapy stepping unit (DK Technologies®, Barum,Germany).…”

Selective biomarkers for inflammation and infection are associated with post-operative complications following transperineal template prostate biopsy (TTPB): a single-centre observational clinical pilot-study

“…Observation after 28 days following TTPB indicated that 310 (0.31%) developed sepsis 757 (0.77%) developed an infection and 950 (0.96%) developed UTI [ 9 ]. Haematuria is a common manifestation of blood loss after TTPB [ 10 , 11 ]. Urinary retention is by far the most common complication observed after TTPB with reported occurrence rates of 16% ( n = 35) [ 10 ], 6.3% ( n = 110) [ 12 ], and 7.9% ( n = 379) [ 13 ].…”