Search Our Scientific Publications & Authors

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 Apr 18. 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

Ocul Oncol Pathol 2021 Mar 30;7(1):54-61. Epub 2020 Nov 30.

Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom.

Purpose: To describe our experience in performing biopsy of post-septal orbital masses with core needle under computerized tomography guidance (CT-CNB).

Methods: The medical records of all patients who underwent this procedure were reviewed. The procedure was performed under local anesthesia on a day case basis under a peribulbar block. Read More

J Urol 2021 Jun 19;205(6):1671-1680. Epub 2021 Feb 19.

Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.

Purpose: Catheter-related bladder discomfort occurs in up to 63% of patients following robot-assisted radical prostatectomy. The optimal intraoperative anesthesia regime to prevent patients from catheter-related bladder discomfort is unknown.

Materials And Methods: A prospective cohort analysis was conducted. Read More

Scand J Urol 2021 Apr 17;55(2):149-154. Epub 2021 Feb 17.

Department of Urology, Shamir Medical Center (Asaf HaRofe), Zerifin, Israel.

Objectives: Trans rectal ultrasound guided prostate biopsy with periprostatic nerve block (PPNB) is performed following probe insertion and manipulation leaving these initial maneuvers uncovered in terms of pain control. We evaluated whether topical analgesia reduces pain during early stages of the procedure.

Patients And Methods: Seven group prospective, randomized controlled study: groups 1-3: nerve block with 5 ml 1% lidocaine bilaterally plus perianal topical application of 10 ml 5% lidocaine cream. Read More

J Endourol 2021 Apr 31;35(4):518-524. Epub 2021 Mar 31.

Departments of Urology, Kaiser Permanente Orange County, and Riverside, California, USA.

We present our series of free-hand transperineal prostate biopsy (fTP-Bx) using a novel coaxial needle introducer guide. All cases were performed in the office under local anesthesia (LA) without sedation. The majority received no prophylactic antibiotics. Read More

J Invest Surg 2021 Feb 8:1-10. Epub 2021 Feb 8.

Medical Faculty Department of Urology, Marmara University, İstanbul, Turkey.

Purpose: To evaluate the effectiveness of caudal block (CB) using dexmedetomidine and pethidine instead of local anesthesia (LA) for prostate needle biopsy and the effect of CB on urinary retention.

Material And Methods: A transrectal ultrasound-guided prostate needle biopsy (TRUS-Bx) was performed on 68 patients with a mean age of 65 ± 2.18 years. Read More

Turk J Med Sci 2021 Feb 4. Epub 2021 Feb 4.

Objective: To establish the relationship between the needle biopsy and the pathology result after radical prostatectomy administrated for prostate cancer.

Methods: We retrospectively analyzed 67 patients who had undergone radical prostatectomy from 2016 to 2019. All surgeries and all biopsies were performed in the third author?s urology department. Read More

BJU Int 2021 Jan 15. Epub 2021 Jan 15.

Churchill Hospital Cancer Centre, Oxford, UK.

Objectives: To assess the feasibility of local anaesthetic transperineal (LATP) technique using a single-freehand transperineal (TP) access device, and report initial prostate cancer (PCa) detection, infection rates, and tolerability.

Patients And Methods: Observational study of a multicentre prospective cohort, including all consecutive cases. LATP was performed in three settings: (i) first biopsy in suspected PCa, (ii) confirmatory biopsies for active surveillance, and (iii) repeat biopsy in suspected PCa. Read More

Prostate Int 2020 Dec 29;8(4):185-189. Epub 2020 May 29.

Erciyes University, Department of Urology, Kayseri, Turkey.

Background: Multiparametric prostate magnetic resonance imaging (mpMRI)-guided fusion prostate biopsy is an emerging technique in the diagnosis of prostate cancer and provides extensive information on the prebiopsy anatomy of the prostate, anus, and rectum. We aimed to investigate the clinical and anatomical risk factors aggravating the pain experienced by patients undergoing mpMRI-guided fusion prostate biopsy.

Methods: The prospective study included 319 patients aged 45-75 years who had a prostate-specific antigen <10 ng/ml and a Prostate Imaging Reporting and Data System ≥3 lesion and underwent combined biopsy (targeted biopsy + 12-core standard prostate biopsy) under local anesthesia (intrarectal lidocaine gel + periprostatic nerve block). Read More

Int Urol Nephrol 2021 Jan 3. Epub 2021 Jan 3.

Faculty of Health Sciences, University of Cape Town, Cape Town, Republic of South Africa.

Purpose: To assess patient satisfaction with the use of portable video media (PVM) for the purpose of taking informed consent for common urological outpatient procedures performed under local anaesthesia.

Methods: Patients undergoing the following procedures were approached for recruitment: flexible cystoscopy with or without biopsy, transrectal ultrasound-guided prostate biopsy or flexible cystoscopy with insertion or removal of a ureteric stent. Audio-visual media were developed for each procedure, with each script translated from English into isiXhosa and Afrikaans. Read More

J Endourol 2021 Apr 17;35(4):525-543. Epub 2021 Feb 17.

Department of Urology, Kaiser Permanente, Irvine, California, USA.

The recent plethora of reports of "free-hand" transperineal prostate biopsy (fTP-Bx) under local anesthesia (LA) demonstrate that many centers consider this technique to be a safer and possibly more accurate approach to prostate biopsy in the clinic setting. The literature was searched for fTP-Bx, and summary tables were compiled. Studies on the costs of postprostate biopsy sepsis were also researched. Read More

Urol Oncol 2020 Nov 27. Epub 2020 Nov 27.

Department of Urology, Oslo University Hospital(,) Oslo. Norway; University of Oslo(,) Oslo. Norway. Electronic address:

Introduction: Transperineal Prostate biopsies (TPBx) are usually performed under general anesthesia without image fusion. This study aimed to evaluate prostate cancer (Pca) detection rates (CDR), pain, and adverse events using a novel, free-hand TPBx technique, based on elastic fusion of magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) under local anesthesia.

Materials And Methods: This multicenter retrospective study included all consecutive patients scheduled for a TPBx. Read More

Urol Clin North Am 2021 Feb;48(1):25-33

Urology Associates and UPMC Western Maryland, 12234 Williams Road, Cumberland, MD 21502, USA. Electronic address:

"Approximately 1 million prostate biopsies are performed each year in the United States. This procedure has traditionally been performed using a transrectal approach, which is associated with a significant risk of infectious complications including sepsis. In recent years, transperineal prostate biopsy has been increasingly adopted due to its lower associated infectious risk. Read More

Prostate Cancer Prostatic Dis 2020 Sep 30. Epub 2020 Sep 30.

SH Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Background: To investigate the feasibility of a freehand transperineal (TP) systematic prostate biopsy protocol under local anaesthesia (LA) and the value of different sectors in diagnosing prostate cancer (PCa).

Methods: A total of 611 consecutive freehand TP biopsies under LA in 2 hospitals were prospectively evaluated. Cancer detection rate in each of the four different sectors (anterior, mid, posterior, basal) was recorded to evaluate the value of each sector. Read More

Niger J Clin Pract 2020 Sep;23(9):1183-1187

Department of Surgery, College of Medicine, University of Benin, Benin City, Edo State, Nigeria.

Aims: This study compared the analgesic effect of apical peri-prostatic block with that of intra-rectal xylocaine gel for trans-rectal ultrasound guided prostate biopsy (TRUS-PBx) in Nigeria.

Methods: This is a prospective randomized comparative study carried out over one year in University of Benin Teaching Hospital, Edo State, Nigeria. The participants were randomized into two groups; Group A had 10 mls of intra-rectal xylocaine gel instillation while Group B had apical infiltration of 10 mls of 1% xylocaine all before TRUS-PBx. Read More

Urologiia 2020 Sep(4):66-72

Republican Specialized Scientific and Practical Medical Center of Urology, Tashkent, Uzbekistan.

Aim: To improve an early diagnosis of prostate cancer (PCa) by clarifying indications for prostate biopsy.

Materials And Methods: A prospective analysis of 251 primary prostate biopsies performed in Republican Specialized Scientific and Practical Medical Center of Urology to patients with LUTS during the period from 2018 to 2019 was carried out. All patients were divided into two groups. Read More

Cent European J Urol 2020 19;73(2):140-145. Epub 2020 Jun 19.

Department of Urology, Yuzuncu Yil University Medical Faculty, Van, Turkey.

Introduction: Although the periprostatic nerve block (PNB) is accepted as the standard method for local anesthesia prior to transrectal ultrasound (TRUS)-guided prostate biopsy, it is not the most ideal method. We aimed to analyze the effectiveness and safety of bilateral pudendal nerve blockage (PuNB) by comparing with PNB.

Material And Methods: Between June 2019 and October 2019, a total of 108 patients with elevated serum prostate specific antigen values (PSA ≥4 ng/ml) and/or abnormal digital rectal examination findings were included in the study. Read More

J Urol 2020 12 6;204(6):1209-1215. Epub 2020 Jul 6.

Department of Urology, San Giovanni Battista Hospital, AOU Città della Salute e della Scienza and University of Turin, Turin, Italy.

Purpose: Several transperineal biopsy series have proven feasibility under local anesthesia. However, there is a lack of large analyses detailing pain outcomes and factors influencing pain.

Materials And Methods: From 2016 to 2019 we performed a multicenter prospective study in men undergoing multiparametric magnetic resonance imaging-transperineal fusion biopsies (target+systematic cores) under local anesthesia. Read More

BJU Int 2021 01 2;127(1):122-130. Epub 2020 Aug 2.

Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy.

Objective: To assess the outcomes of multiparametric magnetic resonance imaging (mpMRI) transperineal targeted fusion biopsy (TPFBx) under local anaesthesia.

Patients And Methods: We prospectively screened 1327 patients with a positive mpMRI undergoing TPFBx (targeted cores and systematic cores) under local anaesthesia, at two tertiary referral institutions, between September 2016 and May 2019, for inclusion in the present study. Primary outcomes were detection of clinically significant prostate cancer (csPCa) defined as (1) International Society of Urological Pathologists (ISUP) grade >1 or ISUP grade 1 with >50% involvement of prostate cancer (PCa) in a single core or in >2 cores (D1) and (2) ISUP grade >1 PCa (D2). Read More

BJU Int 2020 09 5;126(3):329-332. Epub 2020 Aug 5.

Department of Urology, Guy's at St Thomas' Hospitals, London, UK.

Int J Clin Pract 2020 Aug 28;74(8):e13517. Epub 2020 Apr 28.

Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Republic of Korea.

Aims: To investigate whether deep sedation for transrectal prostate biopsy could reduce anxiety and pain and enhance rebiopsy compliance.

Methods: A two-centre prospective observation study was conducted under two different anaesthetic conditions: deep sedation with analgesia and local anaesthesia with lidocaine. A 12-core prostate biopsy was taken in all patients. Read More

Urology 2020 Dec 24;146:25-31. Epub 2020 Apr 24.

Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China. Electronic address:

Objective: To develop and validate a novel perineal nerve block approach for transperineal prostate biopsy.

Patients And Methods: Five adult male cadavers were dissected to delineate the superficial and deep branches of the perineal nerve. Afterwards, 90 out of 115 patients were selected and randomly assigned to receive periprostatic, periapical triangle, or branches of perineal nerve (BPN) block. Read More

Urol J 2020 Mar 14;17(6):597-601. Epub 2020 Mar 14.

Ankara Numune Training and Research Hospital, Department of Urology, Ankara, Turkey.

Purpose: To evaluate the efficacy of caudal regional anesthesia and local anesthesia methods in prostate biopsy applied under transrectal ultrasonography. Matherials and Methods: This prospective study included a total of 160 patients randomly separated into 4 equal groups as intrarectal local anesthesia (IRLA), periprostatic local anesthesia (PPLA), combined local anesthesia (IRLA+PPLA), and caudal regional anesthesia (CRA). The patients were evaluated using the pain scores on a visual analog scale. Read More

Korean J Radiol 2020 04;21(4):422-430

Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. Read More

Actas Urol Esp 2020 04 29;44(3):196-204. Epub 2020 Feb 29.

Hospital Arnau de Vilanova, Valencia, España.

Introduction: Prostate cancer is the most common visceral neoplasm in men and the second one in the United States with the highest mortality behind lung cancer and ahead of colorectal cancer. While prostate cancer mortality rates have been reduced in the United States, Austria, United Kingdom and France, 5-year survival rates have been incremented in Sweden, probably due to a higher diagnostic activity and non-lethal tumor detection. TRPB usually has low rates of serious complications, with a not negligible number of minor complications. Read More

Urology 2020 Jun 13;140:122-131. Epub 2020 Feb 13.

Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy.

Objective: To evaluate the feasibility of "in-office" TPFBx under local anesthesia (LA).

Materials And Methods: We prospectively screened for eligibility data of 724 consecutive men undergoing either TPFBx (target and systematic cores) or TPSBx (systematic cores only) from September 2016 to June 2018 due to suspicion of prostate cancer (CaP), according to predefined exclusion criteria.

Results: We included 459 men (TPFBx n = 279 including n = 338 mpMRI lesions, Pi-RADS 4 in 63. Read More

J Robot Surg 2020 Oct 12;14(5):767-772. Epub 2020 Feb 12.

Department of Urology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore.

This IRB-approved prospective pilot study evaluates the safety and feasibility of performing stereotactic robot-assisted transperineal MRI-US fusion targeted prostate biopsy under local anaesthesia (LA) with sedation. 30 patients who underwent robotic transperineal prostate biopsy between September 2017 and June 2018 were recruited. All biopsies were performed with the iSR'obot Mona Lisa and BK3000 ultrasound system. Read More

Prostate Cancer Prostatic Dis 2020 09 2;23(3):429-434. Epub 2020 Jan 2.

Department of Urology, Cantonal Hospital Aarau, Aarau, Switzerland.

Background: Transrectal (TR) ultrasound-guided prostate biopsy is one of the most commonly performed urologic procedures worldwide. The major drawback of this approach is the associated risk for infectious complications. Sepsis rates are increasing due to rising antibiotic resistance, representing a global issue. Read More

Cent European J Urol 2019 16;72(3):258-262. Epub 2019 Sep 16.

Department of Urology, Hospital de Braga, Portugal.

Introduction: A transrectal ultrasound-guided (TRUS) biopsy is the gold standard for diagnosis of prostatic neoplasia. This exam is associated with pain and discomfort, and numerous methods of analgesia during this procedure have been described. There is still no consensus among urologists about the pain control technique that should be performed, even though the periprostatic basal nerve block is the most studied technique. Read More