Transperineal prostate biopsy: The modern gold standard to prostate cancer diagnosis

Ortner, Gernot; Tzanaki, Eirini; Prasad, Bhavan; Nagele, Udo; Tokas, Theodoros

doi:10.5152/tud.2020.20358

Cited by 15 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…pudendal and digital rectally guided TP periprostatic nerve blocks). 70 , 85 – 87 An analysis of over 1200 patients by Stefanova et al 19 found skin infiltration followed by periprostatic infiltration results in similar discomfort as TR without any change in complications. Szabo et al reviewed 12,000 cases under local anesthesia and found adequate pain control and minimal complications, with a recommendation that it can be integrated into normal clinic workflow with only local anesthesia providing evidence supporting feasibility of TP performance within clinic settings.…”

Section: The Modern Era Of Tp Pbxmentioning

confidence: 99%

Hundred years of transperineal prostate biopsy

Schmeusser

Levin

Lama

et al. 2022

Therapeutic Advances in Urology

View full text Add to dashboard Cite

The earliest recorded efforts to biopsy prostate, in the early 20th century, were made through transperineal (TP) approach, with open perineal prostate biopsy (PBx) being considered the gold standard for prostate cancer (PCa) diagnosis in that era. Later, to minimize morbidity and increase diagnostic accuracy, several technical modifications and transrectal ultrasound (TRUS) assistance were incorporated. However, in the 1980s, the transrectal (TR) approach became the predominant PBx method following the introduction of TRUS-TR PBx with sextant sampling, providing a convenient and efficacious method for prostate sampling. With modernization of PCa diagnosis, a recent resurgence of the TP PBx has been observed, driven primarily by TR drawbacks of infectious complications and sampling limitations. TP PBx is rapidly emerging as the new PBx standard, being officially recommended as the initial approach for biopsy in Europe and is increasingly being conducted and studied in the United States. The modern era of TP PBx is based on the improvements in local anesthesia techniques, TP access systems, and robotic assistance. These modifications and advancements have improved the ease of use, patient comfort, and diagnostic outcomes with TP PBx. Herein, we present a history of the evolution of TP PBx spanning over 100 years and explore the basis of the technique that merits future utilization.

show abstract

Section: The Modern Era Of Tp Pbxmentioning

confidence: 99%

Hundred years of transperineal prostate biopsy

Schmeusser

Levin

Lama

et al. 2022

Therapeutic Advances in Urology

View full text Add to dashboard Cite

show abstract

“…Local anesthesia has recently been utilized with success, allowing room for a speedier process and lower risk of complications that come with general anesthesia. 6 Using a bi-plane TRUS for guidance, four to eight cores are taken from each of the eight sectors in a craniocaudal fashion from apex to base, for a total of 32–64 biopsies depending on volume of prostate. Special care is taken in the anterior zone where biopsy gun can transverse through urethra and increase the risk of complications.…”

Section: Barzell Technique and Its Modificationsmentioning

confidence: 99%

“… 4 , 5 This proposed technique, coupled with the introduction of the transrectal ultrasound (TRUS), displayed superior diagnostic accuracy and remains the standard of care today. 6 However, subsequent studies assessing transrectal biopsy (TR-Bx) in recent years have drawn attention to the higher risks of infectious complications, including hospital admissions due to sepsis. 7 , 8 In addition, a significant number of cancers can be missed by a transrectal approach, particularly in the antero-apical portions of the gland.…”

Section: Introductionmentioning

confidence: 99%

Schema and cancer detection rates for transperineal prostate biopsy templates: a review

Sidana

Blank

Wang

et al. 2022

Therapeutic Advances in Urology

View full text Add to dashboard Cite

Prostate cancer (PCa) is the most common noncutaneous malignancy in men and is the second leading cause of cancer mortality in men in the United States. Current practice requires histopathological confirmation of cancer achieved through biopsy for diagnosis. The transrectal approach for prostate biopsy has been the standard for several decades. However, the risks and limitations of transrectal biopsies have led to a recent resurgence of transperineal prostatic biopsies. Recent studies have demonstrated the transperineal approach for prostate biopsies to be effective, associated with minimal complications and superior in several aspects to traditional transrectal biopsies. While sextant and extended sextant templates are widely accepted templates for transrectal biopsy, there are a diverse set of transperineal biopsy templates available for use, without consensus on the optimal sampling strategy. We aim to critically appraise the salient features of established transperineal biopsy templates.

show abstract

“…Transperineal (TP) biopsy was developed over the last 20 years, but historically has required complex equipment, multiple cores were taken (Template Mapping Biopsy) and general anaesthesia (GA) was needed. 2 Within the UK National Health Service (NHS), the introduction of pre-biopsy MRI has transformed the diagnostic pathway, reducing unnecessary prostate biopsies and improving the detection of CSD, and has paved the way for the development of outpatient targeted and systematic TP biopsy techniques replacing the routine use of Transrectal prostate biopsy. This has become known as the "TRexit" Initiative.…”

Section: Introductionmentioning

confidence: 99%