Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases

Lona Vyas, Peter Acher, Janette Kinsella, Benjamin Challacombe, Richard T. M. Chang, Paul Sturch, Declan Cahill, Ashish Chandra, Rick Popert

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    81 Citations (Scopus)

    Abstract

    Objective

    To describe a protocol for transperineal sector biopsies (TPSB) of the prostate and present the clinical experience of this technique in a UK population.

    Patients and Methods

    A retrospective review of a single-centre experience of TPSB approach was undertaken that preferentially, but not exclusively, targeted the peripheral zone of the prostate with 24-38 cores using a 'sector plan'. Procedures were carried out under general anaesthetic in most patients.

    Between January 2007 and August 2011, 634 consecutive patients underwent TPSB for the following indications: prior negative transrectal biopsy (TRB; 174 men); primary biopsy in men at risk of sepsis (153); further evaluation after low-risk disease diagnosed based on a 12-core TRB (307).

    Results

    Prostate cancer was found in 36% of men after a negative TRB; 17% of these had disease solely in anterior sectors.

    As a primary diagnostic strategy, prostate cancer was diagnosed in 54% of men (median PSA level was 7.4 ng/mL).

    Of men with Gleason 3+3 disease on TRB, 29% were upgraded and went on to have radical treatment.

    Postoperative urinary retention occurred in 11 (1.7%) men, two secondary to clots. Per-urethral bleeding requiring hospital stay occurred in two men. There were no cases of urosepsis.

    Conclusions

    TPSB of the prostate has a role in defining disease previously missed or under-diagnosed by TRB. The procedure has low morbidity.

    Original languageEnglish
    Pages (from-to)32-37
    Number of pages6
    JournalBJU International
    Volume114
    Issue number1
    DOIs
    Publication statusPublished - Jul 2014

    Keywords

    • transperineal biopsy
    • prostate cancer
    • biopsy
    • staging
    • complications
    • active surveillance
    • ACTIVE SURVEILLANCE
    • CANCER
    • COMPLICATIONS

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