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

TY - JOUR

T1 - Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate

T2 - a single centre experience of 634 cases

AU - Vyas, Lona

AU - Acher, Peter

AU - Kinsella, Janette

AU - Challacombe, Benjamin

AU - Chang, Richard T. M.

AU - Sturch, Paul

AU - Cahill, Declan

AU - Chandra, Ashish

AU - Popert, Rick

PY - 2014/7

Y1 - 2014/7

N2 - ObjectiveTo 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 MethodsA 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).ResultsProstate 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.ConclusionsTPSB of the prostate has a role in defining disease previously missed or under-diagnosed by TRB. The procedure has low morbidity.

AB - ObjectiveTo 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 MethodsA 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).ResultsProstate 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.ConclusionsTPSB of the prostate has a role in defining disease previously missed or under-diagnosed by TRB. The procedure has low morbidity.

KW - transperineal biopsy

KW - prostate cancer

KW - biopsy

KW - staging

KW - complications

KW - active surveillance

KW - ACTIVE SURVEILLANCE

KW - CANCER

KW - COMPLICATIONS

U2 - 10.1111/bju.12282

DO - 10.1111/bju.12282

M3 - Article

SN - 1464-4096

VL - 114

SP - 32

EP - 37

JO - BJU International

JF - BJU International

IS - 1

ER -