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Prostate biopsy: results and advantages of the transperineal approach—twenty-year experience of a single center

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Abstract

Purpose

Detection rate for prostate cancer (PCa) and complications following transperineal prostate biopsy (TPBx) were reported.

Methods

From January 1991 to December 2012, 4,000 men underwent TPBx; from 1991 to 2001, the patients underwent biopsy for suspicious DRE or PSA values >4 ng/mL; moreover, from 2002, the indications were abnormal DRE, PSA >10 ng/mL, PSA values between 4.1 and 10, 2.6 and 4 and <2.5 ng/mL with F/T PSA <25, <20 <15 %, respectively. In case of initial biopsy, the number of needles cores increased from 6 (1991–1996) to 12 (1997–2012) and 18 cores (2002–2012); in case of repeat biopsy, since 2005 a saturation biopsy (SPBx) with >24 cores was performed.

Results

Overall, PCa, normal parenchyma, HGPIN and ASAP were found in 1,379 (34.5 %), 2,400 (60 %), 175 (4.4 %) and 46 (1.1 %) patients, respectively; in case of initial TPBx, the scheme at 18 showed a greater PCa detection in comparison with scheme at 6–12 cores (p < 0.05). In case of repeat biopsy, a higher detection of microfocus of cancer was found performing a SPBx; moreover, 15 % of cancers were localized in the anterior zone. Incidence of hemospermia and urinary retention were correlated with the number of needle cores resulting equal to 30.4 versus 11.1 % in case of SPBx (p < 0.05); moreover, none developed sepsis.

Conclusions

Transperineal prostate biopsy (TPBx) resets the risk of sepsis; moreover, in case of repeat SPBx, the transperineal approach detects a high number of significant PCa localized in the anterior zone (15 % of the cases).

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Authors and Affiliations

  1. Urology Unit, Cannizzaro Hospital, Via Messina 829, Catania, Italy

    Pietro Pepe & Francesco Aragona

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  1. Pietro Pepe
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  2. Francesco Aragona
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Correspondence to Pietro Pepe.

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Pepe, P., Aragona, F. Prostate biopsy: results and advantages of the transperineal approach—twenty-year experience of a single center. World J Urol 32, 373–377 (2014). https://doi.org/10.1007/s00345-013-1108-1

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  • DOI: https://doi.org/10.1007/s00345-013-1108-1

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