The detection and upgrade rates of prostate adenocarcinoma following transperineal template-guided prostate biopsy – a tertiary referral centre experience

Abstract

IntroductionWe aim to present transperineal template-guided prostate biopsy (template biopsy) outcomes at a tertiary referral centre. Furthermore, to identify the detection rate of prostate cancer in those with a previous negative transrectal ultrasound guided prostate biopsy and the upgrade rate of those on active surveillance for Gleason 3 + 3 = 6 prostate adenocarcinoma.Material and methodsWe conducted a prospective study of 200 consecutive men who underwent template biopsy over a 22-month period in a tertiary referral centre, using a standard 24 region template prostate biopsy technique. Indications and histology results, as well as complications, were recorded.ResultsMedian age was 67 years and median PSA was 10 ng/mL. Overall detection rate was 47%. 39.5% of cases with previous negative transrectal biopsies were found to have prostate adenocarcinoma. 47.5% of cases on active surveillance for Gleason 3 + 3 = 6 prostate adenocarcinoma were upgraded. The most frequent complication was acute urinary retention at a rate of 12.5%, however, the use of a single prophylactic dose of tamsulosin was found to be beneficial, with 13 cases needed to treat to prevent one episode.ConclusionsTemplate biopsies are safe and efficacious with an overall detection rate of 47% in the present series. Due to the high detection rate, one must consider template biopsy following one negative transrectal biopsy where there is persistent clinical suspicion. Furthermore, those considering active surveillance for Gleason 3 + 3 = 6 disease should be offered template biopsy to confirm the grade of their disease.

Pelvic plexus block to provide better anesthesia in transperineal template-guided prostate biopsy: a randomised controlled trial

“…All of the above studies were meant to explore the anesthetic efficacy of PPB in the transrectal prostate biopsy. Owing to the high positive rate and few complications, The value of TTPB in the diagnosis of Pca is becoming more and more important [2, 3]. Hence, we evaluated the anesthetic efficacy of PPB in TTPB in this study.…”

“…Early screening for prostate cancer (PCa) can significantly lower disease-related morbidity and even prolong life expectancy [1]. Transperineal template-guided prostate biopsy (TTPB) is one of most effective procedures for detection of prostate cancer [2, 3]. However, compared with the transrectal biopsy, transperineal route may cause more pain [4].…”

Initial experience and cancer detection rates of office-based transperineal magnetic resonance imaging-ultrasound fusion prostate biopsy under local anesthesia

“…7 © 2022 Canadian Urological Association transrectal biopsies. 11,[16][17][19][20] Stefanova et al, reported on the results of 1,287 patients undergoing transperineal prostate biopsy in the office using local anesthesia reporting zero major complications or episodes of urosepsis. 20 Minor complications were relatively uncommon (1.9%) with temporary urinary retention representing the majority of minor complications.…”

“…Transperineal prostate biopsies, while a small fraction of prostate biopsies performed, continue to gain traction as many centers phase out transrectal biopsies altogether in an effort to eliminate biopsy associated infection. [16][17]19 In addition, transperineal biopsy obviates the need for antibiotic prophylaxis in almost all patients, offering significant benefit in an era when antibiotic stewardship is critically important. However, perceived requirement for general above the perineum.…”

From Cognitive MR-Targeted Fusion Prostate Biopsy to Radical Prostatectomy: Incidence and Predictors of Gleason Grade Group Upgrading in a Chinese Cohort

“…However, GG inconsistency accounting for upgrades still remains an important clinical issue. It is reported that only 40%-60% of prostate biopsy GGs were consistent with the final prostatectomy [ 3 – 10 ]. Due to the high discrepancy rate from biopsy to prostatectomy, it is urgent for physicians to predict prostate biopsy GG upgrades before surgery.…”