The morbidity of transperineal template‐guided prostate mapping biopsy

Abstract

OBJECTIVE To evaluate the effect of transperineal template‐guided prostate mapping biopsy (TTMB) on urinary, bowel and erectile function. PATIENTS AND METHODS In all, 129 men had TTMB; a median of 56 biopsy cores were obtained per patient. Tamsulosin (0.8 mg daily) was initiated 2 days before TTMB and continued for 2 weeks. The International Prostate Symptom Score (IPSS), Rectal Function Assessment Score (R‐FAS), International Index of Erectile Function (IIEF)‐6 and the postvoid residual volume (PVR) were assessed at baseline and after 30 days, except for the IPSS, which was also assessed at 7 days. Several variables were evaluated as predictors of TTMB‐induced morbidity. RESULTS The mean patient age was 64.7 years with a mean prostate volume of 74.3 mL; 60 men (46.5%) were diagnosed with prostate cancer. After TTMB, 39.4%, 7.1% and 1.6% of patients remained catheter‐dependent at 0, 3 and 6 days. The median catheter‐dependency was 0, 1, 2 and 3 days for prostate volumes of <60, 60–90, 90–120 and >120 mL, respectively. No patient remained catheter‐ dependent for >12 days or required a transurethral resection secondary to TTMB. The mean IPSS before TTMB was 10.4, and was 4.6 and 3.8 at 7 and 30 days. At baseline and 30 days the mean PVR was 35 and 40 mL, and the median R‐FAS and IIEF scores for patients potent before TTMB were 2.0 and 2.2, and 27.0 and 26.0, respectively. CONCLUSIONS TTMB is a promising procedure for diagnosing prostate cancer. TTMB‐related morbidity differs from that of standard TRUS biopsy primarily in the incidence of temporary urinary retention, and is comparable in terms of urinary, bowel and erectile function.

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

“…Although not the focus of this study, we have reported earlier morbidity associated with the procedure. 29 At our institution, TTMB is associated with a 29% rate of acute urinary retention and median catheter dependence of one day for men who required catheterization. In our experience, there have been no serious complications, no episodes of sepsis, no impact on erectile function, and no side effects, which were not self-resolving.…”

“…Post-void residual at baseline and 30 days was nearly identical (34.4 and 34.3 ml). 29 Physicians along with their patients can assess whether the potentially higher yield from TTMB is worth the more involved procedure.…”

Magnetic Resonance - Transrectal Ultrasound Fusion Guided Prostate Biopsy

“…Zaman içinde biyopsi tanı oranını artırmak amacıyla ≥20 parça alınan satürasyon biyopsisi ve transperineal harita biyopsi yöntemleri geliştirilmiştir. Transperineal yaklaşımın genel anestezi gerektirmesi ve artmış morbidite (akut idrar retansiyonu) gibi dezavantajları bulunmaktadır (5,6 …”

Prostate Biopsy in Selecting Candidates for Hemiablative Focal Therapy

“…The morbidity profile of the TP approach differs from that of standard TR biopsies and may have a higher incidence of urinary retention episodes 19 ; this factor has to be taken into account as well. In a direct comparison between the two approaches, Kawakami and associates 20 found no significance differences in the ability to detect and characterize PCa in contrast with Emiliozzi and coworkers, 21 who reported on superiority of the TP approach.…”