Transperineal Sector Prostate Biopsies: A Local Anesthetic Outpatient Technique

Julian B. Smith*, Rick Popert, Martin C. Nuttall, Lona Vyas, Janette Kinsella, Declan Cahill

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    41 Citations (Scopus)

    Abstract

    OBJECTIVE: To describe our technique and determine the feasibility and tolerability of transperineal template prostate (TP) biopsies under local anesthesia ( LA).

    METHODS: Fifty consecutive patients underwent TP biopsies under LA for investigation of an elevated prostate-specific antigen level or risk stratification as part of our active surveillance protocol. Tolerability was evaluated with a visual analog scale assessing probe discomfort, LA infiltration, and the biopsy procurement. Patients were also asked if they would have the procedure again, and in those who had undergone previous transrectal biopsies, how the TP technique compared. Pathologic data, clinical outcomes, and complications were recorded at 2 weeks.

    RESULTS: Mean age was 62.8 years (standard deviation [SD], 6.34 years) and the mean prostate-specific antigen level was 8.49 ng/mL (SD, 6.36 ng/mL). Mean prostate volume was 48.2 mL (SD, 19.4 mL). Mean visual analog scale scores for discomfort caused by the ultrasound probe, LA injections, and biopsies were 3.08 (SD, 1.64), 3.29 (SD, 1.13), and 2.88 (SD, 1.28), respectively. Thirty-four of 50 men (68%) had positive histology, 26 men had Gleason score = 4 + 3, and 3 had recurrent adenocarcinoma after radiotherapy. There were 2 complications: 1 Clavien score 1 and 1 Clavien score 3a.

    CONCLUSION: LA TP biopsies are well tolerated, acceptable, and feasible when carried out within an outpatient setting.

    Original languageEnglish
    Pages (from-to)1344-1349
    Number of pages6
    JournalUrology
    Volume83
    Issue number6
    DOIs
    Publication statusPublished - Jun 2014

    Keywords

    • ACTIVE SURVEILLANCE
    • TEMPLATE BIOPSIES
    • RANDOMIZED-TRIAL
    • MAPPING BIOPSY
    • CANCER
    • MEN

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