World Journal of Urology

, Volume 37, Issue 9, pp 1845–1850 | Cite as

Developing a five-step training model for transperineal prostate biopsies in a naïve residents’ group: a prospective observational randomised study of two different techniques

  • Guglielmo ManticaEmail author
  • Andrea Pacchetti
  • Roberta Aimar
  • Mattia Cerasuolo
  • Federico Dotta
  • Alberto Olivero
  • Giovannalberto Pini
  • Giovanni Passaretti
  • Massimo Maffezzini
  • Carlo Terrone
Original Article



To evaluate a five-step training model for transperineal prostate biopsies (TPPB) and the differences in terms of the detection rate (DR) and the ease of execution when using either the “fan technique” (FT) or the use of a Free Hand technique (FH).


A prospective observational randomised study was conducted from September 2015 to November 2017. Six naïve residents, who underwent the same five-steps training model, were randomly subdivided into two different groups of three residents based on the selected TPPB technique: A (FT) and B (FH). Patient characteristics (age, PSA, prostatic volume, DRE, MRI), intraoperative (operative time, number of samples) and postoperative parameters (histologic, pain) were evaluated in the 2 groups. The overall and stratified DR for PSA ranges and prostate volume (PV), operative time and complications were compared.


The overall detection rate was very high in both groups (FT 58.2% vs FH 59.6%) and not statistically different between the two techniques. There were no differences in terms of complication rates and pain. The FH showed a better detection rate in prostates smaller than 40 cc (p = 0.023) and a faster operative time (p = 0.025) compared to FT.


Within the TPPB, FH is associated with a higher detection rate in patients with prostate < 40 cc compared to an FT when performed by inexperienced trainees. Standardised training organised in consecutive steps seems to contribute to the achievement of overall high detection rates with both methods.


Prostate cancer Prostate biopsy Transperineal prostate biopsy Training Residents 


Author contributions

GM Project development, data analysis and manuscript writing. AP Data collection and data analysis. RA Data collection and data analysis. MC Data collection and data analysis. FD Data collection and data analysis. AO Data collection and data analysis. GP Manuscript editing. GP Manuscript editing. MM Manuscript editing. CT Project development and manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Guglielmo Mantica
    • 1
    • 2
    Email author
  • Andrea Pacchetti
    • 1
  • Roberta Aimar
    • 3
  • Mattia Cerasuolo
    • 1
  • Federico Dotta
    • 1
  • Alberto Olivero
    • 1
  • Giovannalberto Pini
    • 2
  • Giovanni Passaretti
    • 2
  • Massimo Maffezzini
    • 1
  • Carlo Terrone
    • 1
  1. 1.Department of Urology, Policlinico San Martino HospitalUniversity of GenovaGenovaItaly
  2. 2.Department of Urology, San Raffaele Turro HospitalSan Raffaele UniversityMilanItaly
  3. 3.Department of Urology, San Luigi Gonzaga HospitalUniversity of TurinTurinItaly

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