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BMC Urol 2022 May 6;22(1):74. Epub 2022 May 6.

Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.

Objectives: To investigate the causes of missed diagnosis in mpMRI/TRUS fusion-guided targeted prostate biopsy.

Methods: The clinical data of 759 patients who underwent transperineal prostate biopsy from March 2021 to June 2021 at Nanjing DrumTower Hospital were retrospectively analyzed. Twenty-one patients had MRI contraindications. Read More

Prostate Int 2022 Mar 7;10(1):34-37. Epub 2021 Dec 7.

Department of Urology, A.O.U.I. University of Verona, Verona, Italy.

Introduction And Objectives: This study aimed to assess the incidence of urinary tract infections (UTIs) after transperineal prostate biopsy (TP-PB) comparing patients who underwent antibiotic prophylaxis (AP) with patients who had no prophylaxis.

Materials And Methods: This prospective, double-center trial was conducted between August and December 2020. Patient candidates to PB were included with 1:1 allocation to case (Group A-no AP) and control group (Group B-standard AP). Read More

BJUI Compass 2022 May 9;3(3):197-204. Epub 2021 Oct 9.

Department of Urology National University Hospital Singapore.

Objectives: To compare and review the outcomes of transperineal (TP) prostate biopsies with transrectal (TR) biopsies performed under local anaesthesia (LA). A review of the relevant published literature is presented.

Patients And Methods: We prospectively analysed 212 consecutive patients who underwent TP prostate biopsy using the PrecisionPoint™ access system under LA, at our institution from October 2018 to March 2020. Read More

BJUI Compass 2021 Nov 10;2(6):428-435. Epub 2021 Sep 10.

Department of Urology Western Health Melbourne Victoria Australia.

Objectives: To compare data on transperineal template biopsy (TPTB) under general anesthesia (GA) compared with local anesthesia (LA) procedures using the PrecisionPoint™ Transperineal Access System (PPTAS) in relation to tolerability, cancer detection rate, complications, and cost.

Methods: A prospective pilot cohort study of patients undergoing transperineal biopsy was performed. Patients were excluded if they had concurrent flexible cystoscopy or language barriers. Read More

Front Oncol 2022 7;12:785684. Epub 2022 Apr 7.

Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.

Objective: This study aimed to evaluate the pathological concordance from combined systematic and MRI-targeted prostate biopsy to final pathology and to verify the effectiveness of a machine learning-based model with targeted biopsy (TB) features in predicting pathological upgrade.

Materials And Methods: All patients in this study underwent prostate multiparametric MRI (mpMRI), transperineal systematic plus transperineal targeted prostate biopsy under local anesthesia, and robot-assisted laparoscopic radical prostatectomy (RARP) for prostate cancer (PCa) sequentially from October 2016 to February 2020 in two referral centers. For cores with cancer, grade group (GG) and Gleason score were determined by using the 2014 International Society of Urological Pathology (ISUP) guidelines. Read More

J Korean Med Sci 2022 Apr 18;37(15):e115. Epub 2022 Apr 18.

Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: Sedation anesthesia during transrectal ultrasound (TRUS)-guided prostate biopsy is known to decrease patient pain and anxiety, but little is known whether it affects the procedure's prostate cancer detection and complication rates. This study aimed to determine the effect of sedation anesthesia with intravenous (IV) propofol on TRUS-guided prostate biopsy outcomes.

Methods: A retrospective analysis of 2,119 patients who underwent TRUS-guided prostate biopsy between November 2009 and February 2019 was undertaken. Read More

Zhonghua Wai Ke Za Zhi 2022 May;60(5):504-508

Department of Urology, Northern Jiangsu People's Hospital, Yangzhou 225001, China.

Prostate biopsy is the gold standard for the diagnosis of prostate cancer. In order to successfully and effectively complete the biopsy, clinicians should not only select the correct puncture method, but also pay attention to the pain control of patients undergoing puncture. It is necessary to select a reasonable anesthetic method for biopsy. Read More

ANZ J Surg 2022 06 10;92(6):1480-1485. Epub 2022 Mar 10.

Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Background: Transperineal biopsy (TPB) of the prostate has been increasingly utilized as it has reduced infection risks. Traditionally however, it is performed under general anaesthesia, thus it carries a differing set of risks. Recently, new studies have performed TPB under local anaesthesia with success. Read More

Can Urol Assoc J 2022 Feb 28. Epub 2022 Feb 28.

Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States.

Introduction: We aimed to demonstrate feasibility and cancer detection rates of office-based ultrasound-guided transperineal magnetic resonance imaging-ultrasound (MRI-US) fusion (TFB) prostate biopsy under local anesthesia.

Methods: With institutional review board approval, records of men undergoing TFB in the office setting under local anesthesia were reviewed. Baseline patient characteristics, MRI findings, cancer detection rates, and complications were recorded. Read More

Indian J Urol 2022 Jan-Mar;38(1):34-41. Epub 2022 Jan 1.

Department of Urology, Uro-Oncology and Robotic Surgery, Chennai Urology and Robotics Institute, Chennai, Tamil Nadu, India.

Introduction: With the emergence of multidrug-resistant organisms causing urosepsis after transrectal biopsy of prostate, the need for an alternative approach has increased. We assessed the safety and feasibility of transrectal ultrasound (TRUS) guided free-hand transperineal prostate biopsy under local anesthesia (LA) for suspected prostate cancer.

Materials And Methods: This prospective study was conducted from July 2019 to December 2020 in which patients with elevated prostate-specific antigen (PSA) and/or abnormal digital rectal examination underwent magnetic resonance imaging-TRUS cognitive fusion transperineal prostate biopsy (target and systematic) using coaxial needle. Read More

Zhonghua Nan Ke Xue 2021 10;27(10):886-891

Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.

Objective: To investigate the risk factors for clinically significant PCa diagnosed by transrectal ultrasound-guided systematic prostate biopsy in patients with MRI-negative and PSA-abnormal findings.

Methods: From January 2014 to December 2017, 335 male patients with MRI-negative (PI-RADS 2.0 score ≤ 2) and PSA-abnormal (4－30 ng/ml ) findings underwent systematic prostate biopsy guided by transrectal ultrasound under local anesthesia in our department. Read More

Eur Urol 2022 Jan 17;81(1):110-117. Epub 2021 Nov 17.

Department of Urology, Andros Clinics, Arnhem, The Netherlands; Department of Medical Imaging, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. Electronic address:

Background: Transperineal magnetic resonance imaging-transrectal ultrasound fusion guided biopsy (MFGB) is an increasingly popular technique due to increasing rates of biopsy-related infections. However, its widespread implementation has been hampered by the supposed necessity of epidural or general anesthesia.

Objective: To demonstrate the technique, feasibility, and results of transperineal MFGB under local anesthesia, in an ambulatory setting without the administration of prophylactic antibiotics. Read More

Curr Opin Urol 2022 01;32(1):85-90

Department of Urology, NewYork Presbyterian Hospital/Weil Cornell Medicine, New York, New York, USA.

Purpose Of Review: Prostate biopsy is a very commonly performed office procedure leading to the diagnosis of the most prevalent solid-organ malignancy in American men. Although the transrectal technique for prostate biopsy remains the gold standard, there is increasing interest in the transperineal approach as it offers a clean, percutaneous approach that significantly decreases the risk for infection. In this review, we discuss emerging developments in transperineal prostate biopsy that may optimize the way biopsies are performed in clinical practice. Read More

Front Surg 2021 6;8:649822. Epub 2021 Oct 6.

Department of Urology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

Transperineal prostate biopsy is as effective as the transrectal biopsy in detecting prostate cancer and has a lower risk of infection. However, concerning the procedural pain of the transperineal route, a higher level of anaesthesia is needed, which prevents this approach from being widely used. Although several methods of local anaesthesia to relieve pain during transperineal biopsy have been described, few well-designed trials have been conducted to assess the efficacy of local anaesthesia. Read More

Int Urol Nephrol 2021 Dec 30;53(12):2437-2443. Epub 2021 Sep 30.

Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Purpose: To determine whether intrarectal local anesthesia (IRLA) with heated lidocaine gel provides pain reduction during transrectal ultrasound (TRUS)-guided prostate biopsy.

Methods: We conducted a randomized-controlled study with 153 participants who underwent TRUS-guided, systematic 12-core prostate biopsy from May 2018 to June 2019. These participants were divided into three test groups. Read More

Scand J Urol 2021 Dec 29;55(6):434-440. Epub 2021 Sep 29.

Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Objective: The aim of this study was to compare diagnostic and infectious outcomes between MRI-guided transrectal (TR) and transperineal (TP) prostate biopsies, in order to evaluate implementation of local-anaesthesia TP biopsies in a Swedish university hospital setting.

Methods: In this non-randomized observational study, we recruited 105 patients who underwent TR or TP software-based MRI-ultrasound fusion prostate biopsies between April and August 2020. Information on outcome and covariates were obtained from hospital records. Read More

PeerJ 2021 6;9:e12144. Epub 2021 Sep 6.

Department of Urology, Acıbadem Kocaeli Hospital, Kocaeli, Turkey.

Background: Periprostatic infiltration anesthesia (PPIA) and intrarectal topical anesthesia (IRTA) are recommended methods to control pain in transrectal ultrasonographic prostate biopsy (TRUS-Bx). This study evaluates the factors affecting pain during TRUS-Bx, considering the pathologies involved in anorectal pain etiology and comparing the effectiveness of local anesthesia techniques in providing patient comfort.

Material And Methods: We retrospectively evaluated 477 consecutive patients with TRUS-Bx for elevated Prostate Specific Antigen (PSA), abnormal rectal examination findings, or both. Read More

Niger J Clin Pract 2021 Sep;24(9):1380-1384

Department of Surgery, Urology Unit, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos, Nigeria.

Background: Nowadays, the practice of day case surgery (DCS) is an attractive and appealing one with widespread acceptability because of numerous benefits.

Aim: This study aimed at presenting our experience with urologic DCS in a tertiary healthcare center.

Patients And Methods: A 5-year review of all day-case urologic surgeries at our tertiary healthcare center was carried out. Read More

BMC Urol 2021 Sep 16;21(1):132. Epub 2021 Sep 16.

Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.

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. Read More

Anticancer Res 2021 Sep 1;41(9):4395-4400. Epub 2021 Sep 1.

Department of Urology, Oslo University Hospital, Oslo, Norway.

Background/aim: The aim of this study was to evaluate the cancer detection rate (CDR) using magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion-guided transperineal targeted biopsy (TB).

Patients And Methods: We included 401 consecutive patients, of which 161 were biopsy-naïve. All underwent prebiopsy bi-parametric MRI; patients with positive MRI [prostate imaging reporting and data system (PI-RADS≥3)] underwent TB. Read More

Patient Saf Surg 2021 Aug 21;15(1):28. Epub 2021 Aug 21.

Department of Surgery / Division of Urology, Denver Health Medical Center, 777 Bannock St, Denver, Pavilion A, 3RD Floor, Surgery Administration, Denver, CO, 80204, USA.

Background: To describe our experience with outpatient transperineal biopsy (TPB) without antibiotics compared to transrectal biopsy (TRB) with antibiotics and bowel preparation. The literature elicits comparable cancer detection, time, and cost between the two. As antibiotic resistance increases, antimicrobial stewardship is imperative. Read More

Ann Med Surg (Lond) 2021 Aug 16;68:102581. Epub 2021 Jul 16.

Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama City, Osaka, 589-8511, Japan.

Background: Biopsies are widely used for diagnosing metastatic tumors in the bone and soft tissues; however, their usefulness and limitations remain unclear.

Patients And Methods: Biopsies of patients (13 men, 8 women, mean age 76 years) with metastatic tumors in the bone (19 patients) and soft tissues (2 patients) were reviewed retrospectively. Investigators surveyed the lesion sites, medical histories, Eastern Cooperative Oncology Group (ECOG) Performance Status (PS), biopsy sites, methods, comorbidities, diagnoses, treatments, and outcomes. Read More

BJU Int 2022 05 30;129(5):591-600. Epub 2021 Jul 30.

Canterbury Urology Research Trust, Christchurch, New Zealand.

Objective: To determine whether the addition of inhaled methoxyflurane to periprostatic infiltration of local anaesthetic (PILA) during transrectal ultrasonography-guided prostate biopsies (TRUSBs) improved pain and other aspects of the experience.

Patients And Methods: We conducted a multicentre, placebo-controlled, double-blind, randomized phase 3 trial, involving 420 men undergoing their first TRUSB. The intervention was PILA plus a patient-controlled device containing either 3 mL methoxyflurane, or 3 mL 0. Read More

Pharmacoecon Open 2021 Dec 9;5(4):737-753. Epub 2021 Jul 9.

Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, Cambridge, UK.

Background: Biopsy of the prostate for suspected cancer is usually performed transrectally under local anaesthesia in the outpatient clinic setting. As this involves piercing the bowel wall, the procedure is associated with a risk of infection. Recently, devices that facilitate transperineal biopsy approaches have been developed that avoid piercing the bowel and so should reduce the risk of infection. Read More

Urology 2021 09 2;155:33-38. Epub 2021 Jul 2.

Department of Urology, Weill Cornell Medicine, New York Presbyterian, New York, NY; Department of Interventional Radiology, Weill Cornell Medicine, New York Presbyterian, New York, NY.

Objectives: To assess the prostate cancer diagnostic yield, complications, and costs of transperineal prostate biopsies when performed with local anesthesia versus sedation.

Methods: Data were prospectively collected for men undergoing transperineal MRI-targeted biopsy at the outpatient clinic and tertiary hospital of a single center between October 2017 to February 2020. These data included demographic, procedural, and pathologic variables and complications. Read More

J Cancer Res Ther 2021 Apr-Jun;17(2):353-357

Department of Radiation Oncology, Izmir Medical Park Hospital, Izmir, Turkey.

Purpose: The present study evaluates procedure-associated pain and side effects in the gastrointestinal-genitourinary system in patients with early-stage prostate cancer who were treated with image-guided radiotherapy (IGRT), accompanied by an ultrasound-guided transrectal implantation of fiducial markers, without local anesthesia.

Materials And Methods: A total of 46 patients who referred to our clinics between 2012 and 2017 with a diagnosis of early-stage prostate cancer were included in the study. Before undergoing radiotherapy, all patients were implanted with three intraprostatic fiducial markers through the ultrasound-guided transrectal approach without local anesthesia. Read More

J Urol 2021 10 8;206(4):894-902. Epub 2021 Jun 8.

Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Purpose: The freehand (FH) technique of transperineal prostate biopsy using commercialized needle access systems facilitates a reduction in anesthesia requirements from general to local or local/sedation. We sought to compare the efficacy and complication rates of the FH method with those of the standard grid-based (GB) method.

Materials And Methods: The GB method was performed from 2014 to 2018, and the updated FH technique was performed from 2018 to 2020, yielding comparative cohorts of 174 and 304, respectively. Read More

Urology 2021 08 25;154:339-341. Epub 2021 May 25.

Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI. Electronic address:

Objective: Transrectal ultrasound-guided (TRUS) prostate biopsy is associated with a 1%-5% risk of severe sepsis, despite the use of prophylactic antibiotics. Recent studies have demonstrated the feasibility of transperineal (TP) prostate biopsy in the outpatient setting under local anesthetic (LA). We demonstrate the safety, efficacy, and tolerability of our technique for performing TP biopsy under LA in the clinic setting using a reusable needle guide. Read More

J Vis Exp 2021 03 30(169). Epub 2021 Mar 30.

University of California Los Angeles;

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually similar to a fusion biopsy and is performed under local anesthesia in a clinic setting; treatment time is usually less than one hour. Laser insertion is guided by ultrasound; lesion targeting is via magnetic resonance imaging-ultrasound (MRI/US) fusion, as in targeted prostate biopsy. Read More

World J Urol 2021 Oct 18;39(10):3861-3866. Epub 2021 Apr 18.

Department of Urology, Vivantes Klinikum Am Urban Berlin, Dieffenbachstraße 1, 10967, Berlin, Germany.

Purpose: The aim of this study was to assess the post biopsy infection rate, feasibility and prostate cancer (PCa) detection rate (CDR) by performing transperineal MRI-TRUS fusion biopsy of the prostate (TPBx) under local anesthesia (LA) without antibiotic prophylaxis (AP).

Methods: We prospectively screened 766 men with suspicious lesions on mpMRI, an elevated PSA level or a suspect digital examination undergoing MRI-TRUS-TPBx in LA, from May 2019 to July 2020. Patients with the need for antibiotic prophylaxis or without a PI-RADS target lesion were excluded from final analyses. Read More