Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated: a prospective study using patient-reported outcome measures

Abstract

We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 (21.4%) of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy (with 95% scoring <5 in a 0–10 scale). Twelve out of 196 men (6.1%) felt pain immediately after the procedure. Despite a high incidence of symptoms (e.g., up to 75% had some hematuria, 47% suffered some pain), it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization (5.5%). There were no inpatient admissions due to complications (hematuria, sepsis). On repeat questioning at a later time point, only 25/199 (12.6%) of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.

Prevalence of Voiding Dysfunction After Finger-Guided Prostate Needle Biopsy in Nigerian Men

“…This trend is similar to that of Dobruch J et al and Wadhwa et al who recorded the most prevalent moderate LUTS among European men who had prostate biopsy [13,14]. No clear reason has been adduced for these findings except that Dobruch found that most men with localized prostate carcinoma are found in this group of LUTS [13].…”

Patient Reported Outcome Measures for Transperineal Template Prostate Mapping Biopsies in the PICTURE Study

“…Our study adds to literature on PROMs following prostate biopsies through the transperineal route. [15][16][17] Our study differs in that it is the first to report PROMs on men who exclusively underwent a TTPM-biopsy following a prior TRUS-biopsy. The first prospective collection of PROMs data for transperineal biopsies was reported by Wadhwa et al 17 This study only evaluated the short-term PROMs months from the procedure.…”

“…[15][16][17] Our study differs in that it is the first to report PROMs on men who exclusively underwent a TTPM-biopsy following a prior TRUS-biopsy. The first prospective collection of PROMs data for transperineal biopsies was reported by Wadhwa et al 17 This study only evaluated the short-term PROMs months from the procedure. 18 Their study did however used the shorter form of the IIEF questionnaire and also performed a lower number of cores in comparison to our study which was 5mm mapping biopsy of each prostate.…”

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

“…Nevertheless, as described in the introduction, transperineal systematic biopsies cannot yet be safely omitted in favor of a TB only approach. 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] .…”