Systematic prostate biopsy still matters: A comprehensive analysis of MRI/TRUS-fusion targeted prostate biopsies across different indications

Aims: This study aimed to determine the prevalence rates of transrectal ultrasound-guided prostate biopsy-related complications among patients receiving treatment at the large tertiary-care urology clinic of Kingston Public Hospital (KPH), Jamaica. Study Design: Prospective cohort study. Place and Duration of Study: Kingston Public Hospital (KPH), Jamaica from July 2018 to April 2019. Methodology: Our study population included men who underwent prostate biopsy at KPH. Data on demographics and clinical characteristics were collected using purpose-designed questionnaires from consenting patients who underwent prostate biopsy during the stated period. Patients were then followed up for complications 30 days post biopsy. Details regarding hospitalization due to biopsy-related complications were obtained from the medical records. Results: Data from 185 men were included in the final analysis. Among the patients biopsied, 49% were diagnosed with prostate cancer, while 72% experienced at least one complication, mainly non-infectious complications such as hematuria (46%), lower urinary tract symptoms (24%), rectal bleeding (23%), hematospermia (9%), and urinary retention (16%). Overall, a 15% risk of developing infectious complications was observed, with 9% experiencing fever and 3% experiencing both urinary tract infection and epididymo-orchitis. Our data showed a 6% hospitalization rate within 30 days, with all available records suggesting infectious complications. One death from a prostatic abscess was noted. The present study showed that most prostate biopsy complications were minor. Moreover, although bleeding and infectious complications as well as hospitalization rates were consistent with those reported in larger series, our population experienced a slightly higher mortality and urinary retention rate. Conclusion: Overall, our results showed that prostate biopsies performed within our institution are generally safe and well tolerated. Nonetheless, further studies are needed to determine whether morbidity of the procedure remains acceptable.

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Efficacy of additional periprostatic apex nerve block on pain in each of 12 transrectal prostate core biopsies: a retrospective study

BMC Urology ◽

10.1186/s12894-021-00898-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jeong Woo Yoo ◽

Kyo Chul Koo ◽

Byung Ha Chung ◽

Kwang Suk Lee

Keyword(s):

Retrospective Study ◽

Pain Relief ◽

Nerve Block ◽

Prostate Biopsy ◽

Mixed Model ◽

Linear Mixed Model ◽

Prostate Biopsies ◽

Pain Scores ◽

Average Pain ◽

Probe Insertion

Abstract Background We identified pain variation according to prostate biopsy sites and compared differences in pain relief according to the site of periprostatic nerve block (PNB). Methods This retrospective study collected data from 312 patients who underwent transrectal prostate biopsies between January 2019 and August 2020. Patients were stratified into two groups according to the site of local anesthesia (base vs. base and apex PNB), with each block achieved with 2.5 cm3 of 2% lidocaine. Pain scores were assessed using the visual analog scale at the following time points: probe insertion, PNB at base, PNB at apex, each of the 12 core biopsy sites, and 15 min after biopsy. The results were analyzed using a linear mixed model. Results The average pain scores were significantly higher in the base-only PNB group than were those in the base and apex PNB group (3.88 vs 2.82, p < 0.001). In the base-only PNB group, the pain scores increased from base to apex (p < 0.001), and the pain at each site also gradually increased as the biopsy proceeded (p < 0.001). In contrast, in the base and apex PNB group, there was minor change in pain scores throughout the procedure. Conclusions The pain scores varied at each site during the prostate biopsy. The provision of a base and apex PNB provided greater pain relief than does base-only PNB during prostate biopsy.

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Comparison of Cognitive-targeted Biopsy and Systematic Prostate Biopsy for Predicting Radical Prostatectomy Pathology: Upgrading-downgrading and Concordance Rates

Bulletin of Urooncology ◽

10.4274/uob.galenos.2020.1936 ◽

2021 ◽

Vol 20 (2) ◽

pp. 87-91

Author(s):

Eriz Özden ◽

Arif İbiş ◽

Çağrı Akpınar ◽

Eralp Kubilay ◽

Duygu Kankaya ◽

...

Keyword(s):

Radical Prostatectomy ◽

Prostate Biopsy ◽

Targeted Biopsy ◽

Systematic Prostate Biopsy

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Cancer Detection Rates of Systematic and Targeted Prostate Biopsies after Biparametric MRI

Prostate Cancer ◽

10.1155/2020/4626781 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Maudy C. W. Gayet ◽

Anouk A. M. A. van der Aa ◽

Harrie P. Beerlage ◽

Bart Ph Schrier ◽

Maaike Gielens ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Detection ◽

Prostate Biopsy ◽

Detection Rates ◽

Prostate Biopsies ◽

Significant Difference ◽

Significant Pathology ◽

Study Population ◽

Clinically Significant ◽

Control Study

Objective. To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. Methods. An in-patient control study of 82 men undergoing SB and subsequent TB in case of positive prostate MRI between 2015 and 2017 in the Jeroen Bosch Hospital, the Netherlands. Results. Prostate cancer (PCa) was detected in 54.9% with 70.7% agreement between TB and SB. Significant PCa (Gleason score ≥7) was detected in 24.4%. The CDR with TB and SB was 35.4% and 48.8%, respectively (p=0.052). The CDR of significant prostate cancer with TB and SB was both 20.7%. Clinically significant pathology upgrading occurred in 7.3% by adding TB to SB and 22.0% by adding SB to TB. Conclusions. There is no statistically significant difference between CDRs of SB and TB. Both SB and TB miss significant PCas. Moreover, pathology upgrading occurred more often by adding SB to TB than vice versa. This indicates that the omission of SB in this study population might not be justified.

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MultiParametric Magnetic Resonance Imaging-Based Nomogram for Predicting Prostate Cancer and Clinically Significant Prostate Cancer in Men Undergoing Repeat Prostate Biopsy

BioMed Research International ◽

10.1155/2018/6368309 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10

Author(s):

Cong Huang ◽

Gang Song ◽

He Wang ◽

Guangjie Ji ◽

Jie Li ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Prostate Biopsy ◽

Curve Analysis ◽

Resonance Imaging ◽

Decision Curve Analysis ◽

Multiparametric Magnetic Resonance Imaging ◽

Clinically Significant ◽

Systematic Prostate Biopsy

Objective. To develop and internally validate nomograms based on multiparametric magnetic resonance imaging (mpMRI) to predict prostate cancer (PCa) and clinically significant prostate cancer (csPCa) in patients with a previous negative prostate biopsy. Materials and Methods. The clinicopathological parameters of 231 patients who underwent a repeat systematic prostate biopsy and mpMRI were reviewed. Based on Prostate Imaging and Reporting Data System, the mpMRI results were assigned into three groups: Groups “negative,” “suspicious,” and “positive.” Two clinical nomograms for predicting the probabilities of PCa and csPCa were constructed. The performances of nomograms were assessed using area under the receiver operating characteristic curves (AUCs), calibrations, and decision curve analysis. Results. The median PSA was 15.03 ng/ml and abnormal DRE was presented in 14.3% of patients in the entire cohort. PCa was detected in 75 patients (32.5%), and 59 (25.5%) were diagnosed with csPCa. In multivariate analysis, age, prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE), and mpMRI finding were significantly independent predictors for PCa and csPCa (all p < 0.01). Of those patients diagnosed with PCa or csPCa, 20/75 (26.7%) and 18/59 (30.5%) had abnormal DRE finding, respectively. Two mpMRI-based nomograms with super predictive accuracy were constructed (AUCs = 0.878 and 0.927, p < 0.001), and both exhibited excellent calibration. Decision curve analysis also demonstrated a high net benefit across a wide range of probability thresholds. Conclusion. mpMRI combined with age, PSA, PV, and DRE can help predict the probability of PCa and csPCa in patients who underwent a repeat systematic prostate biopsy after a previous negative biopsy. The two nomograms may aid the decision-making process in men with prior benign histology before the performance of repeat prostate biopsy.

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