Transperineal Prostate Biopsy Research Articles

Transperineal prostate biopsy guided by which ultrasound transducer: transrectal or transperineal: a retrospective study.

Prostate biopsies are primarily conducted using either the transrectal or transperineal approach, with the ultrasound probe positioned in the rectum to obtain a clear view of the prostate. Reports on the utilization of transperineal prostate biopsies with the ultrasound probe placed on the perineal skin are limited. A retrospective investigation was conducted on 119 patients who underwent transperineal ultrasound guided transperineal prostate biopsy (TP-TPPB). Additionally, 85 patients who underwent transrectal ultrasound guided transperineal prostate biopsy (TR-TPPB) were included as controls. The prostate cancer detection rates (PCDRs) and postoperative complication rates were compared between the two groups, and their application values were also evaluated. The overall PCDRs were 35.3% (42/119) in the TP-TPPB and 32.9% (28/85) in the TR-TPPB group (χ2=0.122, p=0.727). When categorized by PSA level, there was no significant difference between the two groups in PCDRs in any category (p>0.05). However, the single-needle PCDRs in some regions (L4, L5, R2, and apex) showed significant differences (p<0.05). There was no difference in postoperative complication rates between the groups. The PCDRs and the postoperative complication rates of TP-TPPB and TR-TPPB are similar. However, TP-TPPB requires simpler equipment and does not require intestinal preparation, which is especially useful for patients with rectal contraindications, such as those with severe hemorrhoids and rectal/anal diseases.

Prospective per‐target analysis of the added value of the PrecisionPoint Transperineal Access System in cognitive prostate biopsy of MRI targets

AbstractObjectivesThe objective of this study is to evaluate the diagnostic performance of perineal access cannulas tethered to a biplanar ultrasound probe in cognitive transperineal prostate biopsies of targets identified by multiparametric magnetic resonance imaging (mpMRI) by comparing the results of the PrecisionPoint (PP) Transperineal Access System with the double‐freehand (DFH) technique.Patients and methodsAll patients who underwent cognitive transperineal prostate biopsy of mpMRI targets using the PP or DFH technique between November 2020 and September 2023 were enrolled. All data related to mpMRI target biopsies were stratified by technique, visibility in transrectal ultrasound and analysed by comparing PP versus DFH. A standardised anaesthesia protocol with 1% mepivacaine was used in all biopsies. The tolerability of the procedures was assessed using a visual analogue scale (VAS).ResultsThe number of mpMRI targets sampled was 166 in PP and 242 in DFH. In target biopsies, the PP system was associated with better diagnostic performance for clinically significant prostate cancer (Gleason score ≥3 + 4) compared to DFH for both ultrasound‐visible targets (61.4% vs. 48.0%) and non‐visible targets (41.4% vs. 14.9%) (p = 0.02). A higher rate of positive cores was obtained from targets sampled with PP (57.7% vs. 49.6%, p = 0.0002). The PP system was associated with the retrieval of significantly longer cores (p &lt; 0.0001). There was no significant difference between the techniques regarding pain reported during the biopsy, with a median VAS of 2.7/10, although the PP device required a lower amount of anaesthetic in the periprostatic planes (4.3 ± 2.0 mL vs. 5.9 ± 1.9 mL, p &lt; 0.0001).ConclusionThe PrecisionPoint Transperineal Access System enabled more precise and higher quality biopsies, resulting in improved histological characterisation of prostate cancer compared to the DFH approach. The use of a perineal cannula did not increase the pain perceived by patients and also required less local anaesthetic during the biopsy.

P036 Cutting the controversy – infectious complications after transrectal vs. transperineal prostate biopsy: A systematic review and meta-analysis

P036 Cutting the controversy – infectious complications after transrectal vs. transperineal prostate biopsy: A systematic review and meta-analysis

Decade-long insights into transperineal prostate biopsy in a West China population: temporal trend, targeted and repeat biopsies, and pathological characterization: a comparative study - retrospective cohort.

Decade-long insights into transperineal prostate biopsy in a West China population: temporal trend, targeted and repeat biopsies, and pathological characterization: a comparative study - retrospective cohort.

PO0427: Feasibility and Safety of Transperineal Prostate Biopsy in the Era of Cognitive Fusion Magnetic Resonance Imaging/Ultrasound in Prostate Cancer Detection. Peruvian Experience

PO0427: Feasibility and Safety of Transperineal Prostate Biopsy in the Era of Cognitive Fusion Magnetic Resonance Imaging/Ultrasound in Prostate Cancer Detection. Peruvian Experience

Predictive diagnostic value of mean platelet volume to platelet count and neutrophil to lymphocyte ratios in the gray zone of prostate cancer with tPSA between 4 to 10 ng/mL.

Exploration of the Predictive Diagnostic Value of Mean Platelet Volume to Platelet Count Ratio (MPV/PLT,PVI) and Neutrophil-to-Lymphocyte Ratio (NLR) in the tPSA Gray Zone of Prostate Cancer. A retrospective study was conducted on 65 prostate cancer (Pca) patients and 52 benign prostatic hyperplasia (BPH) patients who underwent transperineal prostate biopsy at Xiangtan Central Hospital from December 2021 to December 2023. Descriptive statistics and logistic regression models were used to investigate the predictive diagnostic value of PVI and NLR in the tPSA gray zone of prostate cancer. Receiver operating characteristic (ROC) curves were constructed based on PVI and NLR values to determine the classification thresholds. A total of 117 patients were enrolled, including 65 cases of prostate cancer (PCa) and 52 cases of benign prostatic hyperplasia (BPH). There were no statistically significant differences in age, BMI, history of hypertension, history of diabetes, history of coronary heart disease, pre-biopsy white blood cell count, history of drinking, history of smoking, and tPSA between the PCa and BPH patients. The results of logistic regression analysis showed that PVI (OR=2.03, 95%CI: 1.34~3.07, P<0.00) and NLR (OR=0.32, 95%CI: 0.18~0.58, P<0.00) were independent predictors for diagnosing prostate cancer in the tPSA gray zone (VIF=1.04).The maximum area under the curve (AUC) for PVI was 0.70, with an optimal cut-off value of 0.05 (P ≤ 0.01). The maximum AUC for NLR was 0.76, with an optimal cut-off value of 2.86 (P ≤ 0.01).The calibration curve showed good consistency between the predicted and actual outcomes in both the PCa and BPH groups, indicating that the nomogram model had good predictive performance.When using PVI and NLR to plot the receiver operating characteristic (ROC) curves to predict the assessment of PCa in the tpsa gray zone, the area under the curve (AUC) for PVI was the largest at 0.70, with an optimal cutoff value of 0.05 (P ≤ 0.01). The AUC for NLR was the largest at 0.76, with an optimal cutoff value of 2.86 (P ≤ 0.01). PVI and NLR have certain predictive diagnostic value for Pca in the tPSA gray zone, and appropriate use of PVI and NLR can improve the positive rate of early screening for Pca in the gray zone.

Factors influencing urinary retention following freehand transperineal prostate biopsy: Insights from a tertiary care center study

ABSTRACT Objectives: In this study, we evaluated the risk factors for urinary retention after freehand transrectal ultrasound (TRUS) guided transperineal prostate biopsy (TPB). Patients and Methods: Data from 102 cases of freehand TPB at a single institution were retrospectively collected and analyzed. All patients underwent magnetic resonance imaging (MRI)-TRUS cognitive fusion TPB using a transperineal needle guide, with systematic biopsies from 10 prostate sectors and additional MRI-guided targeted biopsies. Exclusions comprised patients with coagulation abnormalities, prior prostate surgeries including biopsy, active urinary tract infection, or a lack of pre-biopsy multiparametric MRI. Results: 14/102 (13.72%) had urinary retention and required urethral catheterization for voiding difficulty or discomfort along with a bladder volume of ≥500 ml. Patients with retention exhibited significantly larger prostate volumes (median 75 cc vs. 40 cc; P &lt; 0.05). Receiver operating curve analysis revealed a prostate volume threshold of 57.5 cc and a core number cutoff of 23 for predicting post-TPB urinary retention, with sensitivities of 78.57% and 85.71%, specificities of 75% and 82.95%, positive predictive values of 33.33% and 44.44%, and negative predictive values of 95.75% and 97.33%, respectively, whereas the number of biopsy cores correlated positively with the development of urinary retention (median 25 vs. 22; P &lt; 0.05). Urinary retention was independent of the patient’s age, comorbidities, presenting prostate-specific antigen levels, prebiopsy severity of lower urinary tract symptoms, and use of alpha-blockers. Conclusion: Patients with larger prostates and higher number of biopsy cores are at a higher risk of postfreehand TPB urinary retention and should receive appropriate counselling. Targeted biopsies alone, rather than a full template, may help mitigate urinary retention in these high-risk groups.

Abstract C014: Lower negative predictive value of prostate MRI in Black men

Abstract Introduction: PIRADS scoring with multiparametric-MRI (MRI) has a pooled 90% negative predictive value (NPV) allowing men to defer biopsy while enhancing Gleason Grade group 2-5 (GG2-5) prostate cancer (PCa) detection. PSA density (PSAD) ≥0.15ng/ml/cm3 has been shown to enhance NPV of the prostate MRI in non-Black men. We assessed the performance of the prostate MRI in Black vs. non-Black men by evaluating sensitivity and NPV, and identified a PSAD threshold providing ≥90% NPV in Black men. Methods: We prospectively recruited Black and non-Black men referred to outpatient urology clinics for abnormal PSA or prostate exam in three similar biomarker validation studies from 2017–23 before MRI-informed diagnostic transrectal or transperineal prostate biopsy. We combined this research cohort with a retrospective clinical cohort of clinically similar Black and non-Black men from one academic institution who also underwent prostate MRIs and MRI-informed biopsies for elevated PSA. Trained radiologists used PIRADS version 2.0 or 2.1 for scoring. Results: Following the combination of the research and clinical cohorts, 286 Black men and 965 non-Black men with PSA&amp;lt;15.0ng/ml were included in the analysis. PIRADS ≥3 had an NPV of 77.1% versus 87.6% and a sensitivity of 90.7% vs. 96.3% for GG2-5 PCa in Black versus non-Black men, respectively (both p&amp;lt;0.05). Using PSAD ≥0.09 for Black men with PIRADS 1-2 lesions increased sensitivity to 92.9%. For PIRADS 1-2, GG2-5 PCa frequency was 5.3% higher in Black versus non-Black men with PSAD&amp;lt;0.15, and 11.0% higher in Black versus non-Black men with PSAD≥0.15. For PIRADS=3, GG2-5 PCa frequency was 9.1% higher in Black men with PSAD&amp;lt;0.15 and 27.9% higher for PSAD≥0.15. For PIRADS=4, GG2-5 PCa frequency was 15.9% higher in Black men with PSAD&amp;lt;0.15, and 9.5% higher for PSAD≥0.15. Conclusion: The PIRADS ≥3 threshold has a lower NPV and sensitivity in Black men. A negative prostate MRI requires a PSAD ≥0.09 threshold for safe biopsy deferral in Black men to maintain a sensitivity ≥90%. Citation Format: Sarah Sandlow, Samuel Carbunaru MD, Zequn Sun PhD, Bernice Ofori MPH, Courtney M. P. Hollowell MD, Patricia Vidal MD, Eric Li MD, Edward M. Schaeffer MD, PhD, Peter Gann MD, ScD, Ashley Ross MD, PhD, Shilajit Kundu MD, Adam B. Murphy MD, MBA, MSCI. Lower negative predictive value of prostate MRI in Black men [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C014.

Lesion size may affect diagnostic capabilities of MRI-guided ultrasound fusion biopsy and cognitive targeted biopsy for clinically significant prostate cancer

MRI-guided targeted biopsy (MRGB) was recommended as part of biopsy paradigm of prostate cancers by current guidelines. This study aimed to analyze the diagnostic efficacy of MRGB and systemic biopsy (SB), and to compare diagnostic capabilities within subgroups of MRGB: MRI-cognitive biopsy (MRCB) and MRI-fusion biopsy (MRFB). We retrospectively enrolled patients who underwent MRGB for suspicious malignant lesion(s) identified on MRI in a single tertiary center, sample size was 74 patients. An mpMRI was performed prior to biopsy and reviewed by an experienced radiologist specialized in prostate cancer. Per-person results of MRGB and each concomitant SB were analyzed as independent biopsies for its positive biopsy rate and positive core percentage. Per-lesion results of MRFB and MRCB were compared for the detection rate. Variables of interest were analyzed with t-test, chi-squared test, and logistic regression analysis. Statistical analyses were performed with IBM Statistical Product and Service Solutions (SPSS), Version 23 (IBM, Armonk, New York). Total of 74 patients fulfilled the inclusion criteria and were enrolled. MRFB had higher PCa detection rate comparing to both MRCB and SB (56.1%, 30.3%, and 33.9% respectively, p value = 0.036); clinically significant prostate cancer (csPCa) detection rate was also significantly higher in MRFB group (43.9%, 24.2%, and 16.9% in each group respectively, p value = 0.011). In per-lesion analysis, MRCB and MRFB had no significant difference in PCa and csPCa detection rate (41.0% vs. 26.2% and 29.5% vs. 16.7% respectively, p value = 0.090 and 0.103). In the lesion ≦ 1.3 cm group, MRFB could achieve higher PCa detection rate, comparing to MRCB (36.4% vs. 14.3%, p value = 0.047); there were also higher positive rates for PCa and csPCa per biopsied cores (22.1% vs. 6.8% and 15.6% vs. 2.7%, p value = 0.029 and 0.028, respectively). Further logistic regression of multi-variate analysis in subgroup of lesion ≦ 1.3 cm revealed that PIRADS score and biopsy method were significant predictors of positive biopsy result for PCa (p value = 0.045 and 0.026, respectively) and for csPCa (p value = 0.043 and 0.025, respectively). In patients receiving trans-perineal prostate biopsy, MRFB had higher cancer detection rate than MRCB and SB. In per lesion comparison, MRFB and MRCB had similar diagnostic accuracy. However, in lesions with diameter less than 1.3 cm, MRFB can provided better diagnose value for PCa and csPCa than MRCB.

Diagnostic Pathway Outcomes for Biparametric Magnetic Resonance Imaging-Targeted Lesions Using Cognitive Registration and Freehand Transperineal Prostate Biopsy in Biopsy-Naïve Men (CRAFT Single-Center Study).

Enhanced histological detection of clinically significant prostate cancer is the goal of the prebiopsy imaging pathway. Risk stratification at a prebiopsy meeting can facilitate optimization of lesion targeting. We aimed to evaluate the feasibility of cognitive registration, freehand transperineal prostate biopsy in a biopsy-naïve population following biparametric MRI for the detection of clinically significant disease (International Society of Urological Pathology Grade Group ≥2). A consecutive series of biopsy-naïve men, prospectively recorded between July 2018 and March 2023, were risk-stratified at our prebiopsy meeting following biparametric MRI to undergo either target-only biopsy or target with systematic biopsy. Biopsies were routinely performed under local anesthesia and without antibiotic prophylaxis in the outpatient setting. Overall prostate cancer and clinically significant prostate cancer detection were primary outcomes. Of 1251 biopsies, prostate cancer was detected in 84% and clinically significant disease in 70.6%. Prostate cancer and clinically significant disease were detected in 86.2% and 76.5% of target-only biopsies, respectively, and in 78.7% and 56.3% of target with systematic biopsies. Postbiopsy complication rate was 0.7%. Prebiopsy biparametric MRI with risk stratification at a prebiopsy meeting in the setting of cognitive targeting and freehand transperineal prostate biopsy yielded a high detection of prostate cancer that is comparable to other studies. These data support the use of cognitive registration, freehand transperineal prostate biopsy as safe, feasible, and cost-effective.

Perioperative Care Advances in Ultrasound-Guided Transperineal Prostate Biopsy with Local Anesthesia

This study reviews nursing approaches for patients undergoing ultrasound-guided transperineal prostate biopsy under local anesthesia. It scrutinizes perioperative care, emphasizing patient care, anxiety mitigation, pain management, complication prevention, and post-discharge education. The goal is to establish an evidence-based protocol to enhance patient well-being and hospital experience.

Clinical value of ultrasound-guided full-needle path anesthesia in transperineal prostate biopsy: An observational study.

The pain sensation in a transperineal prostate biopsy was obvious. This study explored the clinical value of ultrasound-guided full-needle path anesthesia in transperineal prostate biopsy. Two hundred patients who underwent ultrasound-guided transperineal prostate biopsy at our department were randomly divided into 2 groups. The control group received routine local infiltration anesthesia, and the experimental group received ultrasound-guided full-needle path anesthesia. Immediately after biopsy, visual analog scoring was used to evaluate pain during the biopsy process. Seven days postbiopsy, telephone follow-up revealed symptoms, such as hematuria and discomfort during urination. The measured data were expressed as x ± s. The 2 groups were compared using the t test, and the differences were statistically significant (P < .05). There were no significant differences in age, prostate-specific antigen (PSA) level, or prostate volume between the 2 groups, and all patients underwent prostate biopsy. The pain score of visual analog score was (2.55 ± 0.88), urination discomfort was (1.86 ± 0.67) days and hematuria time was (2.87 ± 0.91) days in the experimental group after biopsy. In the control group, the pain score of visual analog scale was (4.32 ± 0.94), the urination discomfort was (2.3 ± 0.77) days, and the hematuria time was (2.85 ± 0.83) days. Pain scores and urination discomfort were compared between the 2 groups (P < .01). Pain and urination discomfort associated with prostate biopsy in the experimental group were significantly lower than those in the control group. Ultrasound-guided full needle path anesthesia can alleviate pain sensation in patients undergoing transperineal prostate biopsy and has high clinical value.

Transperineal Is the Way To Go

The evidence available shows that transperineal prostate biopsy is significantly superior to transrectal biopsy in terms of infectious complications and is therefore recommended as the first choice in the European Association of Urology guidelines.

A prospective evaluation of the prostate microbiome in malignant and benign tissue using transperineal biopsy.

The link between the prostate microbiome and prostate cancer remains unclear. Few studies have analyzed the microbiota of prostate tissue, and these have been limited by potential contamination by transrectal biopsy. Transperineal prostate biopsy offers an alternative and avoids fecal cross-contamination. We aim to characterize the prostate microbiome using transperineal biopsy. Patients with clinical suspicion for prostate cancer who were to undergo transperineal prostate biopsy with magnetic resonance imaging(MRI) fusion guidance were prospectively enrolled from 2022 to 2023. Patients were excluded if they had Prostate Imaging Reporting and Data System lesions with scores ≤ 3, a history of prostate biopsy within 1 year, a history of prostate cancer, or antibiotic use within 30 days of biopsy. Tissue was collected from the MRI target lesions and nonneoplastic transitional zone. Bacteria were identified using 16S ribosomal RNA gene sequencing. Across the 42 patients, 76% were found to have prostate cancer. Beta diversity indices differed significantly between the perineum, voided urine, and prostate tissue. There were no beta diversity differences between cancerous or benign tissue, or between pre- and postbiopsy urines. There appear to be unique genera more abundant in cancerous versus benign tissue. There were no differences in alpha diversity indices relative to clinical findings including cancer status, grade, and risk group. We demonstrate a rigorous method to better characterize the prostate microbiome using transperineal biopsy and to limit contamination. These findings provide a framework for future large-scale studies of the microbiome of prostate cancer.

Reply to Editorial Comment on “Current Perceptions, Practice Patterns, and Barriers to Adoption of Transperineal Prostate Biopsy Under Local Anesthesia”

Reply to Editorial Comment on “Current Perceptions, Practice Patterns, and Barriers to Adoption of Transperineal Prostate Biopsy Under Local Anesthesia”

Prostate cancer detection rate with MRI-targeted biopsy alone using outpatient transperineal prostate biopsy.

We aimed to compare the detection rate of prostate cancer (PCa) and clinically significant (cs) PCa by magnetic resonance imaging-guided targeted biopsy (MTBx) alone and MTBx plus systematic biopsy (SBx) using an outpatient transperineal (TP) approach under local anesthesia. A retrospective study of patients who underwent outpatient TP prostate biopsy under local anesthesia at our tertiary institution between 2019 and 2022 was performed. To compare the proportions of PCa and csPCa in both pathways, McNemar's tests were used. Multivariable logistic regression model was fitted to determine the predictors of csPCa. Of 255 men included, 177 (69%) underwent MTBx alone. MTBx had similar detection rate for PCa (56%) and csPCa (47%) compared to the combination of MTBx and SBx (PCa 61%; csPCa 49%; p=0.1 and p=0.3, respectively). MTBx had lower median number of biopsy cores compared to the combination of MTBx and SBx (6 vs. 11, p<0.001). At multivariable logistic regression analysis, age (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.13, p<0.001), prior negative biopsy (OR 0.19, 95% CI 0.09-0.44, p<0.001), prostate-specific antigen density cutoff ≥0.15 (OR 3.17, 95% CI 1.67-6.01, p<0.001), and prostate imaging reporting and data system ≥4 (OR 12.2, 95% CI 4.21-35.6, p<0.001) were independent predictors of csPCa. MTBx showed similar diagnostic performance to the combination of MTBx and SBx in patients undergoing outpatient TP prostate biopsy. Future studies are needed to evaluate the role of MTBx in avoiding unnecessary biopsies.

Decade-long insights into transperineal prostate biopsy in a west China population: Temporal trend, targeted and repeat biopsies, and pathological characterization.

e17004 Background: Despite advances in prostate cancer (PCa) detection, the need for improving diagnostics and in-depth assessment of the latest prostate biopsy (PBx) techniques through extensive, longitudinal studies remains critical. Methods: Data from 10,378 PBx involving 10,038 patients were retrospectively examined. We detailed the yearly changes in PBx numbers and patient diagnoses, the real-world efficacy of PI-RADS scoring, MRI-targeted biopsy (MRI-TBx), and repeat PBx. We also outlined the detection rates and the clinical profiles of non-adenocarcinoma (non-AC) PCa. Results: A consistent annual increase in PBx was witnessed, with the positive rate climbing to approximately 55%. There was a gradual decline in median age, PSA levels, and M1 stage proportion among PCa patients, suggesting an earlier diagnosis trend. However, compared to Western populations, our center's patients had a significantly higher incidence of M1 stage (34% vs. 6%, P&lt;0.001) and, within the M0 category, presented with older age and elevated baseline PSA levels. Integrating MRI-TBx into the 12-core systematic biopsy (SBx) led to a numerical improvement in PCa detection and enhanced ISUP grading accuracy. Merging MRI-TBx with a 6-core SBx achieved a median clinically significant PCa (csPCa) detection rate of 39.76% in men with PSA&lt;20ng/mL, similar to that of MRI-TBx with a 12-core SBx (40.36%). Furthermore, we identified 1,455 men with non-AC PCa, occurring less in localized cases (about 15%) but more in metastatic cases (over 50%), and exhibiting more aggressive characteristics compared to adenocarcinoma-only cases. Besides, among the 305 individuals undergoing repeat PBx, 62 csPCa cases were identified, all of which exhibited lower positive cores, ISUP grading, and M1 stage incidence than men diagnosed by initial PBx. Conclusions: Analyzing a decade's worth of PBx data from one of the largest Asian cohorts offered pivotal insights into the evolving epidemiology and clinical profiles of PBx, which are essential for shaping future diagnostic approaches for PCa.

The effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies.

To evaluate the effectiveness of mapping-targeted biopsies (MTB) on the index lesion for the detection of clinically significant prostate cancer (csPCa) in transperineal fusion-image prostate biopsies. A retrospective analysis was conducted on 309 men with suspected PCa who underwent prostate biopsies at the Creu Blanca reference center in Barcelona, Spain. The Prostate Imaging-Reporting and Data System (PI-RADS v.2.1) of the magnetic resonance images (MRI) were reclassified by an expert radiologist reading of pre-biopsy biparametric MRI used for segmentation of suspected lesions. Transperineal MTB of suspicious lesions and 12-core systematic biopsies were performed using the Artemis™ platform. CsPCa was defined as International Society of Urological Pathology grade group ≥ 2. CsPCa was detected in 192 men (62.1%), with detection rates of 6.3% for PI-RADS 2, 26.8% for PI-RADS 3, 87.3% for PI-RADS 4, and 93.1% for PI-RADS 5. MTB of the index lesion identified 185 csPCa (96.3%). CsPCa was detected solely in systematic biopsies in three cases (1.6%), while an additional four cases (2.1%) were identified only in the second suspected lesion. A predictive model for csPCa detection in MTB of the index lesion was developed, with an AUC of 0.918 (95% CI 0.887-0.950). This model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. MTB of the index lesion was highly effective for identifying csPCa in fusion transperineal prostate biopsies. A developed predictive model successfully reduced the need for almost one quarter of biopsies without missing csPCa cases.

Incidence of Infection Following Local Anesthetic Transperineal Prostate Biopsy: A Single-Centre Experience.

Background Local anesthetic transperineal prostate biopsy (LATP) is a widely used diagnostic procedure for prostate cancer. As a diagnostic procedure, it should carry minimal risk. However, morbidity resulting from prostate biopsy is frequent. Prostate biopsy, like any other intervention, carries a significant risk of various infections, ranging from urinary tract infections (UTIs) to potentially life-threatening conditions like sepsis. Aim This study examined the rate of infections following a prostate biopsy at a single center and sought to identify risk factors that could increase the likelihood of developing an infection. Methods A retrospective review was conducted on all 168 patients who underwent LATP biopsy between 01/04/2022 and 01/04/2023. Data were collected from the Clinical Record and Reporting System (CRRS). Patient characteristics, including age, prostate-specific antigen (PSA) levels, prostate volume, the main indication for the biopsy, number of cores taken, antibiotic prophylaxis, and comorbidities were analyzed.The inclusion criteria encompassed all patients receiving this procedure within the specified timeframe, without restrictions on age, underlying health conditions, or medical history. No exclusion criteria were applied, aiming to comprehensively analyze and capture the full spectrum of patient outcomes and characteristics associated with these biopsies during the study period. Results In terms of socio-demographics, all patients were male with an average age (mean) of 65.5 years, a mean PSA level of 13.9 ng/dL, and an average prostate volume of 66.1 mL. On average, 23.2 biopsy cores were taken. All patients received antibiotic prophylaxis, mainly ciprofloxacin. Despite this, 1.78% of patients (n=3) developed post-biopsy infections. Two of these patients had diabetes mellitus, and two had a large prostate volume of 95 mL.

Editorial Comment on Article “Current Perceptions, Practice Patterns, and Barriers to Adoption of Transperineal Prostate Biopsy Under Local Anesthesia”

Editorial Comment on Article “Current Perceptions, Practice Patterns, and Barriers to Adoption of Transperineal Prostate Biopsy Under Local Anesthesia”