Diagnostic outcomes from transrectal and transperineal prostate biopsies – experiences from a Swedish tertiary care Centre

Abstract

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. We compared detection rates of overall prostate cancer (PCa) and clinically significant PCa (≥ISUP2) between the two groups using simple and multivariable-adjusted analyses. As a secondary outcome, we descriptively compared infection-related outcomes between the two groups.

Results

Of the total population, 72 patients underwent TR and 33 patients underwent TP biopsies. Biopsies were positive for PCa in 50 (69.4%) patients of the TR group and 23 (69.7%) patients of the TP group. Clinically significant cancer was found in 28 (38.9%) patients of the TR group and 10 (30.3%) patients of the TP group. Simple and multivariable-adjusted analyses did not indicate any statistically significant difference between groups. Post-biopsy infection was diagnosed in one patient (3%) of the TP group and eight patients (11.1%) in the TR group, conforming to previous reports of low infection rates after TP biopsies.

Conclusions

Our results conform to data suggesting that the transition from TR to TP MRI-guided biopsies is feasible and safe, maintaining a high diagnostic quality while possibly reducing the risk of infection-related complications.

Keywords:

• Prostate cancer
• prostate biopsy
• transperineal
• MRI-guided
• fusion biopsy
• infection

Disclosure of interest

The authors report no conflicts of interest

Data availability statement

The present dataset is not publicly available, due to patient confidentiality issues, but is available from the corresponding author on reasonable request.