Prostate biopsy approach and complication rates

Mate,Kinga; Nedjim,Saleh; Bellucci,Simon; Boucault,Cesar; Ghaffar,Nael; Constantini,Tracy; Marvanykovi,Fanni; Vestris,Pierre-Gilles; Sadreux,Yvanne; Laguerre,Melanie; Stempfer,Gautier; Blanchet,Pascal; Istvan,Buzogany; Brureau,Laurent

doi:10.3892/ol.2023.13959

Prostate biopsy approach and complication rates

Authors:
- Kinga Mate
- Saleh Nedjim
- Simon Bellucci
- Cesar Boucault
- Nael Ghaffar
- Tracy Constantini
- Fanni Marvanykovi
- Pierre-Gilles Vestris
- Yvanne Sadreux
- Melanie Laguerre
- Gautier Stempfer
- Pascal Blanchet
- Buzogany Istvan
- Laurent Brureau
View Affiliations

Affiliations: Department of Urology, Péterfy Sándor Utcai Hospital‑Clinic and Trauma Centre, Budapest 1076, Hungary, Department of Urology, Ibn Rochd University Hospital, Casablanca 50169, Morocco, Department of Urology, Free University of Brussels, 1050 Brussels, Belgium, Department of Urology, University Hospital of Pointe à Pitre, Les Abymes 97159, Guadeloupe, France
Published online on: July 17, 2023 https://doi.org/10.3892/ol.2023.13959
Article Number: 375
Copyright: © Mate et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Prostate biopsy is the gold standard to confirm prostate cancer. In addition to standard 12‑core biopsies, magnetic resonance imaging (MRI)‑guided prostate biopsies have recently been introduced to improve the detection of clinically significant prostate cancer. The present study aimed to compare the complications after standard transrectal ultrasound‑guided and standard plus targeted (MRI‑guided) prostate biopsies, to study the impact of the number of biopsy cores on complication rates, and to compare complication rates after transrectal ultrasound‑guided prostate biopsies with those following transperineal prostate biopsies from the literature. A prospective study was performed, which included 135 patients who underwent transrectal ultrasound‑guided prostate biopsies between April 1 and June 30, 2022, at the Urology Department of the University Hospital of Pointe à Pitre (Pointe à Pitre, Guadeloupe). A total of 51 patients were excluded because of missing information concerning their post‑biopsy surveillance. The median age at the time of biopsy was 69 years, median prostate‑specific antigen value was 8.9 ng/ml, median prostate volume was 57.5 ml, and median number of cores was 15. A total of 35 of the 84 included patients (41.7%) had a standard biopsy only and 49 (58.3%) had targeted (MRI‑guided) plus standard biopsies. A total of 53 patients (63.1%) experienced early side effects, whereas only 24 patients (28.6%) experienced late side effects. Three patients (3.6%) required hospitalization for post‑biopsy complications. Early side effects, especially hematuria and hematospermia, occurred significantly more frequently in the targeted plus standard group, with more cores taken, with no significant difference concerning late side effects or infectious complications between the standard and standard plus targeted groups. The admission rate for sepsis after transperineal biopsy has been reported to vary between 0 and 1%, whereas the present study had an admission rate of 2.29% using the transrectal approach. Further studies are required to analyze the complications requiring hospitalization after transrectal and transperineal biopsies.

View Figures

View References

1	Overduin CG, Fütterer JJ and Barentsz JO, Futterer JJ and Barentsz JO: MRI-guided biopsy for prostate cancer detection: A systematic review of current clinical results. Curr Urol Rep. 14:209–213. 2013. View Article : Google Scholar : PubMed/NCBI
2	Zattoni F, Marra G, Kasivisvanathan V, Grummet J, Nandurkar R, Ploussard G, Olivier J, Chiu PK, Valerio M, Gontero P, et al: The detection of prostate cancer with magnetic resonance imaging-targeted prostate biopsies is superior with the transperineal vs the transrectal approach. A European association of urology-young academic urologists prostate cancer working group multi-institutional study. J Urol. 208:830–837. 2022. View Article : Google Scholar : PubMed/NCBI
3	Borghesi M, Ahmed H, Nam R, Schaeffer E, Schiavina R, Taneja S, Weidner W and Loeb S: Complications after systematic, random, and image-guided prostate biopsy. Eur Urol. 71:353–365. 2017. View Article : Google Scholar : PubMed/NCBI
4	Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, Rosario DJ, Scattoni V and Lotan Y: Systematic review of complications of prostate biopsy. Eur Urol. 64:876–892. 2013. View Article : Google Scholar : PubMed/NCBI
5	Ghani KR, Dundas D and Patel U: Bleeding after transrectal ultrasonography-guided prostate biopsy: A study of 7-day morbidity after a six-, eight- and 12-core biopsy protocol. BJU Int. 94:1014–1020. 2004. View Article : Google Scholar : PubMed/NCBI
6	Berger AP, Gozzi C, Steiner H, Frauscher F, Varkarakis J, Rogatsch H, Bartsch G and Horninger W: Complication rate of transrectal ultrasound guided prostate biopsy: A comparison among 3 protocols with 6, 10 and 15 cores. J Urol. 171:1478–1481. 2004. View Article : Google Scholar : PubMed/NCBI
7	Ehdaie B, Vertosick E, Spaliviero M, Giallo-Uvino A, Taur Y, O'Sullivan M, Livingston J, Sogani P, Eastham J, Scardino P and Touijer K: The impact of repeat biopsies on infectious complications in men with prostate cancer on active surveillance. J Urol. 191:660–664. 2014. View Article : Google Scholar : PubMed/NCBI
8	Rosario DJ, Lane JA, Metcalfe C, Donovan JL, Doble A, Goodwin L, Davis M, Catto JW, Avery K, Neal DE and Hamdy FC: Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: Prospective evaluation within ProtecT study. BMJ. 344:d78942012. View Article : Google Scholar : PubMed/NCBI
9	Losa A, Gadda GM, Lazzeri M, Lughezzani G, Cardone G, Freschi M, Lista G, Larcher A, Nava LD and Guazzoni G: Complications and quality of life after template-assisted transperineal prostate biopsy in patients eligible for focal therapy. Urology. 81:1291–1296. 2013. View Article : Google Scholar : PubMed/NCBI
10	Tsivian M, Abern MR, Qi P and Polascik TJ: Short-term functional outcomes and complications associated with transperineal template prostate mapping biopsy. Urology. 82:166–170. 2013. View Article : Google Scholar : PubMed/NCBI
11	Pepe P and Aragona F: Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology. 81:1142–1146. 2013. View Article : Google Scholar : PubMed/NCBI
12	Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF and Schrder FH: Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology. 60:826–830. 2002. View Article : Google Scholar : PubMed/NCBI
13	Chowdhury R, Abbas A, Idriz S, Hoy A, Rutherford EE and Smart JM: Should warfarin or aspirin be stopped prior to prostate biopsy? An analysis of bleeding complications related to increasing sample number regimes. Clin Radiol. 67:e64–e70. 2012. View Article : Google Scholar : PubMed/NCBI
14	Nam RK, Saskin R, Lee Y, Liu Y, Law C, Klotz LH, Loblaw DA, Trachtenberg J, Stanimirovic A, Simor AE, et al: Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol. 189 (1 Suppl):S12–S18. 2013. View Article : Google Scholar : PubMed/NCBI
15	Pinkhasov GI, Lin YK, Palmerola R, Smith P, Mahon F, Kaag MG, Dagen JE, Harpster LE, Reese CT and Raman JD: Complications following prostate needle biopsy requiring hospital admission or emergency department visits-experience from 1000 consecutive cases. BJU Int. 110:369–374. 2012. View Article : Google Scholar : PubMed/NCBI
16	Manoharan M, Ayyathurai R, Nieder AM and Soloway MS: Hemospermia following transrectal ultrasound-guided prostate biopsy: A prospective study. Prostate Cancer Prostatic Dis. 10:283–287. 2007. View Article : Google Scholar : PubMed/NCBI
17	Klein T, Palisaar RJ, Holz A, Brock M, Noldus J and Hinkel A: The impact of prostate biopsy and periprostatic nerve block on erectile and voiding function: A prospective study. J Urol. 184:1447–1452. 2010. View Article : Google Scholar : PubMed/NCBI
18	Aktas BK, Bulut S, Gokkaya CS, Ozden C, Salar R, Aslan Y, Baykam MM and Memis A: Association of prostate volume with voiding impairment and deterioration in quality of life after prostate biopsy. Urology. 83:617–621. 2014. View Article : Google Scholar : PubMed/NCBI
19	Anastasiadis E, van der Meulen J and Emberton M: Hospital admissions after transrectal ultrasound-guided biopsy of the prostate in men diagnosed with prostate cancer: A database analysis in England. Int J Urol. 22:181–186. 2015. View Article : Google Scholar : PubMed/NCBI
20	Grummet JP, Weerakoon M, Huang S, Lawrentschuk N, Frydenberg M, Moon DA, O'Reilly M and Murphy D: Sepsis and ‘superbugs’: Should we favour the transperineal over the transrectal approach for prostate biopsy? BJU Int. 114:384–388. 2014.PubMed/NCBI
21	Vyas L, Acher P, Kinsella J, Challacombe B, Chang RT, Sturch P, Cahill D, Chandra A and Popert R: Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: A single centre experience of 634 cases. BJU Int. 114:32–37. 2014. View Article : Google Scholar : PubMed/NCBI
22	Namekawa T, Fukasawa S, Komaru A, Kobayashi M, Imamura Y, Ohzeki T, Takagi K, Sato Y, Akakura K, Ichikawa T and Ueda T: Prospective evaluation of the safety of transrectal ultrasound-guided transperineal prostate biopsy based on adverse events. Int J Clin Oncol. 20:1185–1191. 2015. View Article : Google Scholar : PubMed/NCBI
23	Penzkofer T, Tuncali K, Fedorov A, Song SE, Tokuda J, Fennessy FM, Vangel MG, Kibel AS, Mulkern RV, Wells WM, et al: Transperineal in-bore 3-T MR imaging-guided prostate biopsy: A prospective clinical observational study. Radiology. 274:170–180. 2015. View Article : Google Scholar : PubMed/NCBI
24	Panebianco V, Barchetti F, Manenti G, Aversa T, Catalano C and Simonetti G: MR imaging-guided prostate biopsy: Technical features and preliminary results. Radiol Med. 120:571–578. 2015. View Article : Google Scholar : PubMed/NCBI
25	Kuru TH, Roethke MC, Seidenader J, Simpfendörfer T, Boxler S, Alammar K, Rieker P, Popeneciu VI, Roth W, Pahernik S, et al: Critical evaluation of magnetic resonance imaging targeted, transrectal ultrasound guided transperineal fusion biopsy for detection of prostate cancer. J Urol. 190:1380–1386. 2013. View Article : Google Scholar : PubMed/NCBI
26	Pal RP, Elmussareh M, Chanawani M and Khan MA: The role of a standardized 36 core template-assisted transperineal prostate biopsy technique in patients with previously negative transrectal ultrasonography-guided prostate biopsies. BJU Int. 109:367–371. 2012. View Article : Google Scholar : PubMed/NCBI
27	Suzuki M, Kawakami S, Asano T, Masuda H, Saito K, Koga F, Fujii Y and Kihara K: Safety of transperineal 14-core systematic prostate biopsy in diabetic men. Int J Urol. 16:930–935. 2009. View Article : Google Scholar : PubMed/NCBI
28	Kubo Y, Kawakami S, Numao N, Takazawa R, Fujii Y, Masuda H, Tsujii T and Kihara K: Simple and effective local anesthesia for transperineal extended prostate biopsy: Application to three-dimensional 26-core biopsy. Int J Urol. 16:420–423. 2009. View Article : Google Scholar : PubMed/NCBI
29	Merrick GS, Taubenslag W, Andreini H, Brammer S, Butler WM, Adamovich E, Allen Z, Anderson R and Wallner KE: The morbidity of transperineal template-guided prostate mapping biopsy. BJU Int. 101:1524–1529. 2008. View Article : Google Scholar : PubMed/NCBI
30	Hara R, Jo Y, Fujii T, Kondo N, Yokoyoma T, Miyaji Y and Nagai A: Optimal approach for prostate cancer detection as initial biopsy: Prospective randomized study comparing transperineal versus transrectal systematic 12-core biopsy. Urology. 71:191–195. 2008. View Article : Google Scholar : PubMed/NCBI
31	Li H, Yan W, Zhou Y, Ji Z and Chen J: Transperineal ultrasound-guided saturation biopsies using 11-region template of prostate: Report of 303 cases. Urology. 70:1157–1161. 2007. View Article : Google Scholar : PubMed/NCBI
32	Pinkstaff DM, Igel TC, Petrou SP, Broderick GA, Wehle MJ and Young PR: Systematic transperineal ultrasound-guided template biopsy of the prostate: Three-year experience. Urology. 65:735–739. 2005. View Article : Google Scholar : PubMed/NCBI
33	Emiliozzi P, Corsetti A, Tassi B, Federico G, Martini M and Pansadoro V: Best approach for prostate cancer detection: A prospective study on transperineal versus transrectal six-core prostate biopsy. Urology. 61:961–966. 2003. View Article : Google Scholar : PubMed/NCBI
34	Symons JL, Huo A, Yuen CL, Haynes AM, Matthews J, Sutherland RL, Brenner P and Stricker PD: Outcomes of transperineal template-guided prostate biopsy in 409 patients. BJU Int. 112:585–593. 2013. View Article : Google Scholar : PubMed/NCBI
35	Ekwueme K, Simpson H, Zakhour H and Parr NJ: Transperineal template-guided saturation biopsy using a modified technique: Outcome of 270 cases requiring repeat prostate biopsy. BJU Int. 111:E365–E373. 2013. View Article : Google Scholar : PubMed/NCBI
36	Dimmen M, Vlatkovic L, Hole KH, Nesland JM, Brennhovd B and Axcrona K: Transperineal prostate biopsy detects significant cancer in patients with elevated prostate-specific antigen (PSA) levels and previous negative transrectal biopsies. BJU Int. 110:E69–E75. 2012. View Article : Google Scholar : PubMed/NCBI
37	Yamamoto S, Kin U, Nakamura K, Hamano M, Nishikawa Y, Takenouchi T and Maruoka M: Transperineal ultrasound-guided 12-core systematic biopsy of the prostate for patients with a prostate-specific antigen level of 2.5–20 ng/ml in Japan. Int J Clin Oncol. 10:117–121. 2005. View Article : Google Scholar : PubMed/NCBI
38	Miller J, Perumalla C and Heap G: Complications of transrectal versus transperineal prostate biopsy. ANZ J Surg. 75:48–50. 2005. View Article : Google Scholar : PubMed/NCBI