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

Basourakos, Spyridon P.; Alshak, Mark N.; Lewicki, Patrick; Cheng, Emily H.; Tzeng, Michael; DeRosa, Antonio; Allaway, Mathew J.; Ross, Ashley E.; Schaeffer, Edward M.; Patel, Hiten D.; Hu, Jim C.; Gorin, Michael A.

doi:10.1016/j.euros.2022.01.001

Cited by 29 publications

(21 citation statements)

References 125 publications

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“…This observation is consistent with other reports regardless of method for performing transperineal prostate biopsy. 41 …”

Section: Discussionmentioning

confidence: 99%

“…This observation is consistent with other reports regardless of method for performing transperineal prostate biopsy. 41 One critique of the analysed literature on the PrecisionPoint device is the relative lack of direct comparisons between use of this device and other various methods for performing transperineal prostate biopsy. With that said, the literature has consistently shown a benefit in terms of shorter procedure times with the PrecisionPoint device as compared to grid-based techniques.…”

Section: Discussionmentioning

confidence: 99%

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Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

et al. 2022

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Objectives: To report the results of a pooled analysis evaluating the cancer detection rates, complications, and tolerability of prostate biopsies performed using the Preci-sionPoint Transperineal Access System. Patients and Methods:The medical literature was reviewed to identify studies published prior to 1 October 2021 evaluating the PrecisionPoint device for performance of transperineal prostate biopsy. Pooled analyses were performed to assess overall and clinically significant cancer detection rates. Additionally, data on complications as well as patient tolerability of the procedure when performed under local anaesthesia were extracted.Results: Transperineal biopsy with the PrecisionPoint Transperineal Access System achieved overall and clinically significant cancer detection rates of 67.9% and 42.6%, respectively. Among patients with Prostate Imaging Reporting and Data System 3, 4, and 5 lesions on prostate magnetic resonance imaging, clinically significant disease was found in 31.7%, 55.7%, and 71.8% of patients, respectively. Complications were rare, with sepsis reported in 4 (0.1%) of 3411 procedures despite frequent omission of antibiotic prophylaxis. Patients reported acceptable tolerability of the procedure when performed under local anaesthesia.Conclusions: Within the available medical literature, there is uniform evidence supporting the use of the PrecisionPoint Transperineal Access System for performing prostate biopsy procedures. The reported cancer detection and infectious complication rates with this device are in line with other methods for performing transperineal prostate biopsy. A unique aspect of the PrecisionPoint device is its ability to facilitate performing transperineal prostate biopsy under local anaesthesia. This factor will likely lead to increased adoption of the beneficial transperineal approach to prostate biopsy.

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“…This observation is consistent with other reports regardless of method for performing transperineal prostate biopsy. 41 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

et al. 2022

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“…Second, the effect on the gut microbiome may not be solely due to the antibiotic effect, and the effect of TPPBx on the gut microbiome without antibiotics was not previously studied. However, there are recent studies showing that the probability of septic infections after TPPBx without prophylactic antibiotics is low ( Basourakos et al, 2022 ). Further studies could be designed to have patients undergo TPPBx without antibiotics to understand its impact on the gut microbiota.…”

Section: Discussionmentioning

confidence: 99%

Oral antibiotics perturbation on gut microbiota after prostate biopsy

Wang

Lau

et al. 2022

Front. Cell. Infect. Microbiol.

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IntroductionThe use of antibiotics may induce the changes in gut microbiota. Previous studies have shown conflicting results on whether the changed gut microbiota by antibiotics can be recovered. Our study aims to investigate whether the gut microbiota could be recovered after a single dose of oral co-amoxiclav before transrectal ultrasound-guided transperineal prostate biopsy (TPPBx) in 5 weeks’ time.MethodsFifteen patients with elevated serum prostate-specific antigen (PSA) were recruited to provide pre-antibiotic and post-antibiotic fecal samples. The V4 region of 16S rRNA was sequenced. Analysis was performed by QIIME2. Alpha- and beta-diversities were analyzed, as well as the differential enrichment by Linear discriminant analysis Effect Size (LEfSe) analysis.ResultsBoth the alpha- and beta-diversities of the pre- and post-antibiotic fecal samples were significantly different. Genera that are associated with alleviation of inflammation were enriched in the pre-antibiotic fecal samples, while the inflammation-associated genera were more enriched in the post-antibiotic fecal samples.ConclusionA single dose of oral co-amoxiclav before TPPBx could have led to a change of gut microbiota that cannot be recovered in 5 weeks' time. Microbiome studies on prostate cancer patients should be cautioned on the use of post-prostate biopsy fecal sampling. Further studies should be conducted for the impact on gut microbiome for TPPBx alone.

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“…Transperineal biopsy has a low risk of infection (16). And studies have shown that the risk of severe hematuria and infection following TTPB is related to the number of cores obtained (17,18).…”

Section: Discussionmentioning

confidence: 99%

Application of single-point prostate biopsy in elderly patients with highly suspected prostate cancer

Luan

Xiao²,

Ding³

et al. 2022

Front. Oncol.

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ObjectiveTo explore the feasibility of single-point prostate biopsy in elderly patients with highly suspected prostate cancer.MethodsForty-three patients with a prostate imaging reporting and data system score (PI-RADS) of 5, age ≥ 80 years and/or PSA ≥ 100 ng/ml and/or Eastern Cooperative Oncology Group score ≥ 2 were enrolled in our hospital from March 2020 to June 2022. Targeted surgery of these patients was performed using only precise local anesthesia in the biopsy area. The biopsy tissues were examined by intraoperative frozen section examination (IFSE). If the result of IFSE was negative, traditional systematic biopsy and further routine pathological examination were performed. The positive rate of biopsy, operation time, complications and pain score were recorded.ResultsThe positive rate of prostate biopsy was 94.7%. The results of IFSE in two patients were negative, and the routine pathological results of further systematic biopsy of those patients were also negative. The visual analog scale and visual numeric scale were 2 (2-4) and 3 (2-3), respectively, during the biopsy procedure. The mean time of operation was 8.5 ± 2.1 min from the beginning of anesthesia to the end of biopsy. It took 35.3 ± 18.7 minutes to obtain the pathological report of IFSE. The incidences of complication hematuria and urinary retention were 10.5% and 2.6%, respectively.ConclusionFor elderly patients with highly suspected prostate cancer, single-point prostate biopsy can be used to quickly and safely obtain pathological results.

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

Cited by 29 publications

References 125 publications

Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

Oral antibiotics perturbation on gut microbiota after prostate biopsy

Application of single-point prostate biopsy in elderly patients with highly suspected prostate cancer

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