MP44-16 NON-INFECTIOUS ADVERSE EVENTS OF TRANSPERINEAL PROSTATE BIOPSIES PERFORMED UNDER LOCAL ANESTHESIA IN AN OUTPATIENT SETTING: RESULTS FROM THE NORAPP STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP44-16 NON-INFECTIOUS ADVERSE EVENTS OF TRANSPERINEAL PROSTATE BIOPSIES PERFORMED UNDER LOCAL ANESTHESIA IN AN OUTPATIENT SETTING: RESULTS FROM THE NORAPP STUDY Maciej Jacewicz, Erik Rud, and Eduard Baco Maciej JacewiczMaciej Jacewicz More articles by this author , Erik RudErik Rud More articles by this author , and Eduard BacoEduard Baco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003290.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of our study was to examine the feasibility and adverse events of transperineal prostate biopsies (TPBx) performed under local anesthesia (LA) in an outpatient setting. METHODS: Patients with suspicion of prostate cancer were included in this randomized clinical trial. Primary endpoint was examining the role of antibiotic prophylaxis in TPBx. Secondary endpoints were pain during and after the procedure (VAS), hematuria, hematospermia and acute urinary retention (AUR). Patients with a high risk of infection were excluded. Free-hand MRI-TRUS fusion TPBx, using the Koelis Trinity device, were performed in an outpatient setting under LA. 40 ml of 1% Lidocaine and 4 ml Sodium Bicarbonate was injected in the perineal skin, under the prostatic apex, in levator ani bilaterally and along the path of the needle under TRUS guidance. Target biopsies were performed in patients with PIRADS ≥3 on MRI, systematic biopsies were performed in biopsy naïve and MRI negative patients. VAS was reported immediately after biopsy, followup regarding non-infectious adverse events was after 2 weeks and 2 months. Correlation was analyzed using Pearson coefficient. RESULTS: We included 402 patients. Median age was 69 years (IQR 63-74, range: 38-86), PSA 7.0 ng/ml (IQR 4.5-11) and prostate volume (PV) 40 ml (IQR 27-58). Median number of cores was 8 (IQR 6-10). Response rate to the questionnaire was 100% (401/402). Median VAS during the placement of LA was 1 (IQR: 1-2, range 0-8) and VAS during biopsy 1 (IQR:1-2, range: 0-8). Additional LA was required by 10% (40/401). There was a weak correlation between age and VAS during placement of LA (r: -0.293, p: <0.001), age and VAS during biopsy (r: -0.243 p:<0.001) and number of cores and VAS during biopsy (r:0.137, p=0.006). There was no correlation between VAS and PV. Median post-procedural VAS was 0 (IQR: 0-0, range 0-5), 2% (9/401) used analgesics after the procedure. Hematuria was present in 64% (258/401), median duration was 3 days (IQR:2-7, range 1-35). There was a weak correlation between number of cores and hematuria (r:0.180, p:<0.001. Hematospermia was present in 54% (197/366) of patients, median duration was 14 days (IQR:7-21, range 1-49). AUR occurred in two patients (0.5%, 95% CI:0.1-1.8). One suffered a clot retention resolved by single time catheterization, the other was treated with a permanent catheter for a week. CONCLUSIONS: Transperineal prostate biopsies under LA can safely be performed in an outpatient setting with limited discomfort to the patient and few non-infectious adverse events. Source of Funding: Oslo University Hospital © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e618 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maciej Jacewicz More articles by this author Erik Rud More articles by this author Eduard Baco More articles by this author Expand All Advertisement PDF downloadLoading ...