Contemporary practice of prostate biopsy in Nigeria: Differences in technique and prophylactic measures among urologist

Objectives: Prostate cancer is the most common cancer affecting men in Nigeria. Trans-rectal ultrasound-guided biopsy of the prostate is routinely performed to diagnose prostate cancer. Though safe, prostate biopsy may be associated with some complications. In Nigeria, there are scanty national guidelines on prophylactic measures and techniques in prostate biopsy. The aim of the study was to assess the pre-biopsy prophylactic measures and biopsy protocols employed by Nigerian Urologists. Material and Methods: A survey questionnaire was distributed during the 2019 Annual General Meeting of the Nigerian Association of Urologic Surgeons and information collected on the biopsy route, use of anesthesia, antibiotic prophylaxis, number of samples taken, and possible complications. Results: A total of 72 urologists participated in the study. Bowel preparation was performed by 10 (13.9%) participants for a duration of 1–3 days. All urologists used the transrectal route and anesthesia was given by all. Prophylactic antibiotics were given by all participants. Our participants administered antibiotic prophylaxis for a period of 1, 3, 5, or 7 days (4.2%, 23.6%, 43.1%, and 22.2%, respectively). Ciprofloxacin/metronidazole combination was most commonly prescribed (70.8%). Most urologists (69.4%) commonly take between 8 and 12 core tissues per biopsy session. The most common complication was hemorrhage (43.1%), followed by perineal pain (40.3%). Conclusion: There is a lack of evenness in pre-biopsy prophylactic measures and biopsy protocol among Nigerian Urologists. There is a need for a Nigerian guideline to elucidate the most appropriate antibiotic(s), route of administration and duration of treatment, the preferred anesthesia type, and the number of core-tissues that are appropriate.

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Hepatitis C Transmission after Prostate Biopsy

Case Reports in Urology ◽

10.1155/2013/797248 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Karim Ferhi ◽

Morgan Rouprêt ◽

Pierre Mozer ◽

Guillaume Ploussard ◽

Alain Haertig ◽

...

Keyword(s):

Prostate Cancer ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Antibiotic Prophylaxis ◽

Prostate Biopsy ◽

Viral Transmission ◽

Risk Of Infection ◽

Ultrasound Probe ◽

Transrectal Prostate Biopsy ◽

A Current

Prostate biopsy is a current and well-codified procedure; antibiotic prophylaxis and rectal enema limit the risk of infection. To date, there has been no reported viral transmission between patients due to a contaminated ultrasound probe. In this study, we report the case of a patient who contracted the hepatitis C virus after transrectal prostate biopsy as part of an individual screening for prostate cancer.

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Updating of the ERSPC Rotterdam Prostate Cancer Risk Calculator for initial prostate biopsy to contemporary practice including the 2014 ISUP Gleason grading and cribriform growth patterns

European Urology Supplements ◽

10.1016/s1569-9056(16)30424-9 ◽

2016 ◽

Vol 15 (13) ◽

pp. e1622-e1624

Author(s):

M. Roobol ◽

J. Verbeek ◽

C. Kweldam ◽

A. Van Leenders

Keyword(s):

Prostate Cancer ◽

Cancer Risk ◽

Prostate Biopsy ◽

Prostate Cancer Risk ◽

Growth Patterns ◽

Risk Calculator ◽

Gleason Grading ◽

Contemporary Practice

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Is Prostate Biopsy Essential to Diagnose Prostate Cancer in the Older Patient with Extremely High Prostate-Specific Antigen?

Korean Journal of Urology ◽

10.4111/kju.2012.53.2.82 ◽

2012 ◽

Vol 53 (2) ◽

pp. 82 ◽

Cited By ~ 7

Author(s):

Jee Young Jang ◽

Young Sig Kim

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Prostate Biopsy ◽

Specific Antigen ◽

Older Patient ◽

Diagnose Prostate Cancer

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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Alone or Combined with Prostate-Specific Antigen for the Diagnosis of Clinically Significant Prostate Cancer

10.21203/rs.3.rs-100942/v1 ◽

2020 ◽

Author(s):

Sat Prasad Nepal ◽

Takehiko Nakasato ◽

Yoshio Ogawa ◽

Yoshihiro Nakagami ◽

Takeshi Shichijo ◽

...

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Gleason Score ◽

Prostate Biopsy ◽

Specific Antigen ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Diagnose Prostate Cancer ◽

Clinically Significant ◽

Insignificant Prostate Cancer

Abstract Background: Many patients undergo unwanted prostate biopsy due to unreliability of prostate-specific antigen (PSA). PSA density (PSAD), free PSA, free-to-total PSA ratio, prebiopsy MRI are used to diagnose prostate cancer (PCa). Since 1863, correlations between inflammation and cancer have been identified and explored; thus, the role of various blood parameters in detecting cancer has been studied, especially neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Here, we evaluated whether these parameters before prostate biopsy can diagnose prostate cancer in our hospital.Methods: We conducted a retrospective study from January 2014 to January 2018. Prostate cancer patients were divided into significant cancer (Gleason Score ≥ 7) and insignificant cancer (Gleason Score < 7). NLR, PLR, and other clinical parameters were taken before the prostate biopsy. We then analyzed the associations of NLR and PLR alone or with PSA, with significant prostate cancer. Results: We included 463 patients, of whom 60.3% (279) had prostate cancer and 75.6 % (211) had a Gleason score (GS) of ≥ 7. PSA and PSAD in the clinically significant prostate cancer patient group were around two times more than those in the insignificant prostate cancer group. PV, NLR, PLR, and combined markers were more in the GS ≥ 7 population group. PSA combined with PLR (PPLR) and PSA with NLR (PNLR) had better area under a curve (AUC) (0.732 and 0.730, resp.), with statistical significance, than PSA, NLR, and PLR alone (0.723, 0.585, and 0.590). In the multivariate analysis using separate models with PSA and NLR or PLR compared to age, DRE-positive lesions, PV, PSAD; PNLR, and PPLR were statistically significant in finding aggressive prostate cancer. When combined markers were used together, despite the high correlations, PSA and NLR were nearly significant (p = 0.062) in detecting the GS ≥ 7 population.Conclusion: The combined use of PSA with PLR and PSA with NLR helps detect the differences between clinically significant and insignificant prostate cancer.

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The use of anaesthetic for transrectal ultrasound-guided prostate biopsy

Ultrasound ◽

10.1258/ult.2012.011051 ◽

2012 ◽

Vol 20 (2) ◽

pp. 98-103

Author(s):

K Jan ◽

S M Mak ◽

N Ley ◽

G Naisby ◽

D Chadwick

Keyword(s):

Prostate Cancer ◽

Prostate Biopsy ◽

Local Anaesthetic ◽

Gold Standard ◽

Transrectal Ultrasound ◽

Prostate Cancer Risk ◽

Complication Rates ◽

Ultrasound Guided ◽

National Guidelines ◽

The Impact

Background Transrectal ultrasound-guided prostate biopsy is the gold standard technique for detecting prostate cancer, undertaken routinely without the use of local anaesthetic (LA) in our institution. Current national guidelines provided by The NHS Prostate Cancer Risk Management Programme and the National Institute for Health and Clinical Excellence recommend and support the use of local anaesthetic injection as the most effective form of pain relief. Methods The primary aim of the study was to assess the impact of the introduction of national guidelines on the patient's pain perception of the procedure. Secondary aims were to compare the complication rates, i.e. bleeding, symptoms of infection and acceptance of a repeat procedure. A quantitative comparative study was performed. After the procedure, pain was evaluated using a questionnaire containing a visual analogue scale. A total of 75 consecutive patients’ prospective, anonymized questionnaire data, from those who were given LA, were compared with data from 75 patients who underwent prostate biopsy before the introduction of local anaesthetic. Data were analysed using two independent samples tests. Results The study findings supported the national clinical guidelines in the routine use of local anaesthetic during transrectal ultrasound-guided prostate biopsy: by demonstrating improvement in pain score, decreased reported discomfort and increased tolerability with no additional significant morbidity or complications. Conclusion The study has informed future policy and protocols by providing evidence based practice. Current working practice has changed to the routine offer of LA and is at present considered the gold standard.

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