1
|
Sandberg M, Whitman W, Greenberg J, Hingu J, Thakker P, Rong A, Bercu C, Dabagian H, Davis R, Hemal A, Tsivian M, Rodriguez AR. Risk factors for infection and acute urinary retention following transperineal prostate biopsy. Int Urol Nephrol 2024; 56:819-826. [PMID: 37902926 DOI: 10.1007/s11255-023-03854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/11/2023] [Indexed: 11/01/2023]
Abstract
PURPOSE To calculate the frequency of infection and acute urinary retention (AUR) following transperineal (TP) prostate biopsy at a single high-volume academic institution and determine risk factors for developing these post-biopsy conditions. METHODS Men undergoing TP prostate biopsy from 2012 to 2022 at our institution were retrospectively identified and chart reviewed. TP biopsies were performed with TR ultrasound (TRUS) guidance with anesthesia using a brachytherapy grid template. TRUS volumes were recorded during the procedure, and magnetic resonance imaging (MRI) volumes were calculated using the ellipsoid formula. When available, MRI volume was used for all analysis, and when absent, TRUS volume was used. AUR was defined as requiring urinary catheter placement within 72 h post-biopsy for inability to urinate. Univariable analysis was performed and variables with p < 0.1 and/or established clinical relevance were included in a backward binary logistic regression to produce an optimized model that fit the data without collinearity between variables. RESULTS A total of 767 TP biopsies were completed in the study window. The frequency of infection was 1.83% (N = 14/767). The total frequency of AUR was 5.48% (N = 42/767). On multivariable regression, patients who went into AUR were five times as likely to develop infection (p = 0.020). Patients with infection post-TP biopsy were four times as likely to develop AUR (p = 0.047) and with prostates > 61.21 cc were three times as likely (p = 0.019). CONCLUSION According to our model, AUR is the greatest risk factor for infection post-TP biopsy. With regard to AUR risks, infection post-biopsy and prostate size > 61.21 cc are the greatest risk factors.
Collapse
Affiliation(s)
- Maxwell Sandberg
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
| | - Wyatt Whitman
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Jacob Greenberg
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Janmejay Hingu
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Parth Thakker
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Anita Rong
- Wake Forest University School of Medicine, Winston Salem, NC, 27101, USA
| | - Caleb Bercu
- Wake Forest University School of Medicine, Winston Salem, NC, 27101, USA
| | - Hannah Dabagian
- Wake Forest University School of Medicine, Winston Salem, NC, 27101, USA
| | - Ronald Davis
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Ashok Hemal
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Matvey Tsivian
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Alejandro R Rodriguez
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| |
Collapse
|
2
|
Osama S, Serboiu C, Taciuc IA, Angelescu E, Petcu C, Priporeanu TA, Marinescu A, Costache A. Current Approach to Complications and Difficulties during Transrectal Ultrasound-Guided Prostate Biopsies. J Clin Med 2024; 13:487. [PMID: 38256621 PMCID: PMC10816968 DOI: 10.3390/jcm13020487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Prostate cancer is one of the most common male malignancies worldwide. It affects middle-aged men (45-60 years) and is the leading cause of cancer-related mortality in Western countries. The TRUS (trans rectal ultrasound)-guided prostate biopsy has been a standard procedure in prostate cancer detection for more than thirty years, and it is recommended in male patients with an abnormal PSA (prostate-specific antigens) or abnormalities found during digital rectal examinations. During this procedure, urologists might encounter difficulties which may cause subsequent complications. This manuscript aims to present both the complications and the technical difficulties that may occur during TRUS-guided prostate biopsy, along with resolutions and solutions found in the specialized literature. The conclusions of this manuscript will note that the TRUS-guided prostate biopsy remains a solid, cost-efficient, and safe procedure with which to diagnose prostate cancer. The complications are usually self-limiting and do not require additional medical assistance. The difficulties posed by the procedure can be safely overcome if there are no other available alternatives. Open communication with the patients improves both pre- and post-procedure compliance.
Collapse
Affiliation(s)
- Salloum Osama
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050096 Bucharest, Romania; (S.O.); (I.-A.T.); (A.C.)
| | - Crenguta Serboiu
- Cellular Biology and Histology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Iulian-Alexandru Taciuc
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050096 Bucharest, Romania; (S.O.); (I.-A.T.); (A.C.)
| | - Emil Angelescu
- Urology Department, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania; (E.A.); (T.A.P.)
| | - Costin Petcu
- Urology Department, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania; (E.A.); (T.A.P.)
| | - Tiberiu Alexandru Priporeanu
- Urology Department, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania; (E.A.); (T.A.P.)
| | - Andreea Marinescu
- Radiology and Imaging Department, Carol Davila University of Medicine and Pharmacy, 050095 Bucharest, Romania
| | - Adrian Costache
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050096 Bucharest, Romania; (S.O.); (I.-A.T.); (A.C.)
| |
Collapse
|
3
|
Malewski W, Milecki T, Szempliński S, Tayara O, Kuncman Ł, Kryst P, Nyk Ł. Prostate Biopsy in the Case of PIRADS 5-Is Systematic Biopsy Mandatory? J Clin Med 2023; 12:5612. [PMID: 37685679 PMCID: PMC10488368 DOI: 10.3390/jcm12175612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023] Open
Abstract
Combining systematic biopsy (SB) with targeted biopsy (TB) in the case of a positive result from multiparametric magnetic resonance imaging (mpMRI) is a matter of debate. The Prostate Imaging Reporting and Data System (PIRADS) score of 5 indicates the highest probability of clinically significant prostate cancer (csPC) detection in TB. Potentially, omitting SB in the case of PIRADS 5 may have a marginal impact on the csPC detection rate. The aim of this study was to determine whether SB can be avoided in the case of PIRADS 5 and to identify potential factors allowing for performing TB only. This cohort study involved n = 225 patients with PIRADS 5 on mpMRI (PIRADS 2.0/2.1) who underwent transperineal or transrectal combined biopsy (CB). CsPC was diagnosed in 51.6% (n = 116/225) of cases. TB and SB resulted in the detection of csPC in 48% (n = 108/225) and 20.4% (n = 46/225) of cases, respectively (TB vs. SB, p < 0.001). When the TB was positive, SB detected csPC in n = 38 of the cases (38/108 = 35%). SB added to TB significantly improved csPC detection in 6.9% of cases in absolute terms (n = 8/116) (TB vs. CB, p = 0.008). The multivariate regression model proved that the significant predictors of csPC detection via SB were the densities of the prostate-specific antigen-PSAD > 0.17 ng/mL2 (OR = 4.038, 95%CI: 1.568-10.398); primary biopsy setting (OR = 2.818, 95%CI: 1.334-5.952); and abnormal digital rectal examination (DRE) (OR = 2.746, 95%CI: 1.328-5.678). In a primary biopsy setting (n = 103), SB detected 10% (n = 6/60) of the additional cases of csPC (p = 0.031), while in a repeat biopsy setting (n = 122), SB detected 3.5% (n = 2/56) of the additional cases of csPC (p = 0.5). In the case of PSAD > 0.17 ng/mL2 (n = 151), SB detected 7.4% (n = 7/95) of additional cases of csPC (p = 0.016), while in the case of PSAD < 0.17 ng/mL2 (n = 74), SB detected 4.8% (n = 1/21) of the additional cases of csPC (p = 1.0). The omission of SB had an impact on the csPC diagnosis rate in patients with PIRADS 5 score lesions. Patients who have already undergone prostate biopsy and those with low PSAD are at a lower risk of missing csPC when SB is avoided. However, performing TB only may result in missing other csPC foci located outside the index lesion, which can alter treatment decisions.
Collapse
Affiliation(s)
- Wojciech Malewski
- Second Department of Urology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (W.M.); (P.K.)
| | - Tomasz Milecki
- Department of Urology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Stanisław Szempliński
- Second Department of Urology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (W.M.); (P.K.)
| | - Omar Tayara
- Second Department of Urology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (W.M.); (P.K.)
| | - Łukasz Kuncman
- Department of Radiotherapy, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Piotr Kryst
- Second Department of Urology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (W.M.); (P.K.)
| | - Łukasz Nyk
- Second Department of Urology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (W.M.); (P.K.)
| |
Collapse
|
4
|
Luan Y, Xiao Q, Ding XF, Zhu LY, Han YX, Chen HP, Huang TB, Lu SM. Application of single-point prostate biopsy in elderly patients with highly suspected prostate cancer. Front Oncol 2022; 12:983805. [PMID: 36313635 PMCID: PMC9614063 DOI: 10.3389/fonc.2022.983805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objective To explore the feasibility of single-point prostate biopsy in elderly patients with highly suspected prostate cancer. Methods Forty-three patients with a prostate imaging reporting and data system score (PI-RADS) of 5, age ≥ 80 years and/or PSA ≥ 100 ng/ml and/or Eastern Cooperative Oncology Group score ≥ 2 were enrolled in our hospital from March 2020 to June 2022. Targeted surgery of these patients was performed using only precise local anesthesia in the biopsy area. The biopsy tissues were examined by intraoperative frozen section examination (IFSE). If the result of IFSE was negative, traditional systematic biopsy and further routine pathological examination were performed. The positive rate of biopsy, operation time, complications and pain score were recorded. Results The positive rate of prostate biopsy was 94.7%. The results of IFSE in two patients were negative, and the routine pathological results of further systematic biopsy of those patients were also negative. The visual analog scale and visual numeric scale were 2 (2-4) and 3 (2-3), respectively, during the biopsy procedure. The mean time of operation was 8.5 ± 2.1 min from the beginning of anesthesia to the end of biopsy. It took 35.3 ± 18.7 minutes to obtain the pathological report of IFSE. The incidences of complication hematuria and urinary retention were 10.5% and 2.6%, respectively. Conclusion For elderly patients with highly suspected prostate cancer, single-point prostate biopsy can be used to quickly and safely obtain pathological results.
Collapse
|
5
|
|
6
|
Ding XF, Luan Y, Xia AL, Zhu LY, Xiao Q, Chen J, Chen HP, Han YX, Liu Z. Application of 16 G Biopsy Needle in Transperineal Template-Guided Prostate Biopsy. Urol Int 2021; 106:909-913. [PMID: 34915528 DOI: 10.1159/000520373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the clinical value of 16 G biopsy needle in transperineal template-guided prostate biopsy (TTPB), compared with 18 G biopsy needle. METHODS The patients who underwent TTPB from August 2020 to February 2021 were randomized into 2 groups using a random number table. The control group (n = 65) and the observation group (n = 58) performed biopsy with 18 G (Bard MC l820) and 16 G (Bard MC l616) biopsy needles, respectively. Positive rate of biopsy, Gleason score, complications, and pain score were statistically analyzed. RESULTS The age, prostate volume, PSA, and the number of cores were comparable between the 2 groups. The positive rate of biopsy in the observation group was 68.9% (40/58), meanwhile the control group was 46.2% (30/65). There was statistical difference between the 2 groups (p = 0.011). Gleason score of the observation group (8 [7-9]) was higher than that of the control group (8 [6-9]) (p = 0.038). There was no significant difference in pain score and complications including hematuria, hematospermia, perineal hematoma, infection, and urinary retention between the 2 groups (p > 0.05). CONCLUSIONS 16 G biopsy needle significantly improved the positive rates and accurately evaluate the nature of lesions, meanwhile did not increase the incidence of complications compared with 18 G biopsy needle.
Collapse
Affiliation(s)
- Xue-Fei Ding
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yang Luan
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - An-le Xia
- Dongtai People's Hospital, Dongtai, China
| | - Liang-Yong Zhu
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Qin Xiao
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Ji Chen
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Hao-Peng Chen
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yue-Xing Han
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Zhong Liu
- Clinical Medical College, Yangzhou University, Yangzhou, China
| |
Collapse
|
7
|
Significant Inter- and Intralaboratory Variation in Gleason Grading of Prostate Cancer: A Nationwide Study of 35,258 Patients in The Netherlands. Cancers (Basel) 2021; 13:cancers13215378. [PMID: 34771542 PMCID: PMC8582481 DOI: 10.3390/cancers13215378] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Gleason grading of prostate cancer is essential for treatment strategies and patient prognosis. Previous studies showed grading variation between pathologists when grading prostate cancer. Our study analyzed the presence and extent of grading variation between and within pathology laboratories in The Netherlands. In our nationwide retrospective study, we analyzed prostate needle biopsy reports of 35,258 patients in The Netherlands graded by 40 pathology laboratories. We found a considerable variation between and within pathology laboratories, as over half of the laboratories graded significantly different from the national mean. This likely affects treatment strategy and prognosis assessment of prostate cancer patients. Abstract Purpose: Our aim was to analyze grading variation between pathology laboratories and between pathologists within individual laboratories using nationwide real-life data. Methods: We retrieved synoptic (n = 13,397) and narrative (n = 29,377) needle biopsy reports from the Dutch Pathology Registry and prostate-specific antigen values from The Netherlands Cancer Registration for prostate cancer patients diagnosed between January 2017 and December 2019. We determined laboratory-specific proportions per histologic grade and unadjusted odds ratios (ORs) for International Society of Urological Pathologists Grades 1 vs. 2–5 for 40 laboratories due to treatment implications for higher grades. Pathologist-specific proportions were determined for 21 laboratories that consented to this part of analysis. The synoptic reports of 21 laboratories were used for analysis of case-mix correction for PSA, age, year of diagnosis, number of biopsies and positive cores. Results: A total of 38,321 reports of 35,258 patients were included. Grade 1 ranged between 19.7% and 44.3% per laboratory (national mean = 34.1%). Out of 40 laboratories, 22 (55%) reported a significantly deviant OR, ranging from 0.48 (95% confidence interval (CI) 0.39–0.59) to 1.54 (CI 1.22–1.93). Case-mix correction was performed for 10,294 reports, altering the status of 3/21 (14%) laboratories, but increasing the observed variation (20.8% vs. 17.7%). Within 15/21 (71%) of laboratories, significant inter-pathologist variation existed. Conclusion: Substantial variation in prostate cancer grading was observed between and within Dutch pathology laboratories. Case-mix correction did not explain the variation. Better standardization of prostate cancer grading is warranted to optimize and harmonize treatment.
Collapse
|
8
|
Sigle A, Suarez-Ibarrola R, Pudimat M, Michaelis J, Jilg CA, Miernik A, Grabbert MT, Schultze-Seemann W, Gratzke C, Schlager D. Safety and side effects of transperineal prostate biopsy without antibiotic prophylaxis. Urol Oncol 2021; 39:782.e1-782.e5. [PMID: 33736977 DOI: 10.1016/j.urolonc.2021.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/22/2021] [Accepted: 02/21/2021] [Indexed: 11/17/2022]
Abstract
STUDY AIMS To investigate safety and side effects of transperineal prostate biopsy without antibiotic prophylaxis. Secondary aim was to identify whether the number of cores influenced the occurrence of complications. PATIENTS AND METHODS A cohort of 184 patients undergoing perineal prostate biopsy without antibiotic prophylaxis from 2015 to 2017 was analyzed retrospectively. On average, 41 cores were taken via two perineal skin punctures. Demographic and clinical data were obtained from patients´ electronic medical records. Binary logistic regression was performed to identify predictors for complications with the following covariates: age, prostate specific antigen (PSA), prostate volume, Prostate Imaging Reporting and Data System score, history of prostatitis, therapeutic anticoagulation, risk factors for urinary tract infection, surgery duration, and the number of biopsy cores. Furthermore, we calculated chi-squared tests with post hoc analyses for differences in the occurrence of complications between quartiles of the above-mentioned parameters. RESULTS The overall complication rate was 10.8% (20/185). Out of 20, 19 (95 %) complications were ≤ grade 2 according to the Clavien-Dindo classification. There were two cases of afebrile urinary tract infection, and no patient developed fever or sepsis. Acute urinary retention was reported in 10 patients (5.4 %). The total number of cores was not associated to infectious complications or acute urinary retention rates. CONCLUSIONS Transperineal prostate biopsy without antibiotic prophylaxis is a safe procedure. Neither postoperative fever nor sepsis occurred. An increased number of cores through two skin punctures was not associated with more complications.
Collapse
Affiliation(s)
- August Sigle
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany.
| | - Rodrigo Suarez-Ibarrola
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Marian Pudimat
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Jakob Michaelis
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Cordula A Jilg
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Markus T Grabbert
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Wolfgang Schultze-Seemann
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Christian Gratzke
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| | - Daniel Schlager
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg, Germany
| |
Collapse
|
9
|
Rahman IA, Nusaly IF, Syahrir S, Nusaly H, Kasim F. Optimizing biopsy strategy for prostate cancer: Bayesian framework of network meta-analysis and hierarchical summary receiver operating characteristic model for diagnostic accuracy. INDIAN JOURNAL OF UROLOGY : IJU : JOURNAL OF THE UROLOGICAL SOCIETY OF INDIA 2021; 37:20-31. [PMID: 33850352 PMCID: PMC8033239 DOI: 10.4103/iju.iju_187_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/24/2020] [Accepted: 10/12/2020] [Indexed: 12/09/2022]
Abstract
Overdiagnosis and overtreatment are well known problems in prostate cancer (PCa). The transrectal ultrasound (TRUS) Guided biopsy (GB) as a current gold standard investigation has a low positive detection rate resulting in unnecessary biopsies. The choice of optimal biopsy strategy needs to be defined. Therefore, we undertook a Bayesian network meta analysis (NMA) and Bayesian prediction in the hierarchical summary receiver operating characteristic (HSROC) model to present a method for optimizing biopsy strategy in PCa. Twenty eight relevant studies were retrieved through online databases of EMBASE, MEDLINE, and CENTRAL up to February 2020. Markov chain Monte Carlo simulation and Surface Under the Cumulative RAnking curve were used to calculate the rank probability using odds ratio with 95% credible interval. HSROC model was used to formulate the predicted true sensitivity and specificity of each biopsy strategy. Six different PCa biopsy strategies including transrectal ultrasound GB (TRUS GB), fusion GB (FUS GB), fusion + transrectal ultrasound GB (FUS + TRUS GB), magnetic resonance imaging GB (MRI GB), transperineal ultrasound GB (TPUS GB), and contrast enhanced ultrasound GB were analyzed in this study with a total of 7584 patients. These strategies were analyzed on five outcomes including detection rate of overall PCa, clinically significant PCa, insignificant PCa, complication rate, and HSROC. The rank probability showed that the overall PCa detection rate was higher in FUS + TRUS GB, MRI GB, and FUS GB. In terms of clinically significant PCa detection, FUS + TRUS GB and FUS GB had a relatively higher clinically significant PCa detection rate, whereas TRUS GB had a relatively lower rate for clinically significant PCa detection rate. MRI GB (91% and 81%) and FUS GB (82% and 83%) had the highest predicted true sensitivity and specificity, respectively, whereas TRUS GB (62% and 83%) had a lower predicted true sensitivity and specificity. MRI GB, FUS GB, and FUS + TRUS GB were associated with lower complication rate, whereas TPUS GB and TRUS GB were more associated with higher complication rate. This NMA and HSROC model highlight the important finding that FUS + TRUS GB, FUS GB, and MRI GB were superior compared with other strategies to avoid the overdiagnosis and overtreatment of PCa. FUS GB, MRI GB, and FUS + TRUS GB had lower complication rates. These results may assist in shared decision making between patients, carers, and their surgeons.
Collapse
Affiliation(s)
- Ilham Akbar Rahman
- Department of Urology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Ilham Fauzan Nusaly
- Department of Urology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Syakri Syahrir
- Department of Urology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Harry Nusaly
- Department of Urology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Firdaus Kasim
- Department of Public Health, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| |
Collapse
|
10
|
Ding XF, Luan Y, Lu SM, Zhou GC, Huang TB, Zhu LY, Guo CH. Risk factors for infection complications after transrectal ultrasound-guided transperineal prostate biopsy. World J Urol 2020; 39:2463-2467. [PMID: 32949254 DOI: 10.1007/s00345-020-03454-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To investigate the influence factors of infection complications of transrectal ultrasound-guided transperineal prostate biopsy. METHODS A total of 2192 patients who underwent prostate biopsy under transperineal prostate biopsy were analyzed retrospectively from December 2010 to May 2020.We collected the clinical characteristics and the incidence of complications, and used univariate and multivariate logistic regression analyses to analyze independent risk factors for infection complications after transperineal prostate biopsy. RESULTS Univariate analysis showed that the following factors were associated with the infection complications: diabetes, bacterial prostatitis, history of urinary retention, history of urinary infection, and number of cores. Furthermore, multivariate logistic analysis revealed that diabetes (OR 2.037, 95% CI 1.143-3.572, P = 0.021) and history of urinary retention (OR 2.563, 95% CI 1.284-3.901, P = 0.013) were independent risk factors for infection complications after transperineal prostate biopsy. CONCLUSIONS Patients with diabetes and history of urinary retention were more likely to have infection complications after transperineal prostate biopsy.
Collapse
Affiliation(s)
- Xue-Fei Ding
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China
| | - Yang Luan
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China.
| | - Sheng-Ming Lu
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China
| | - Guang-Chen Zhou
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China
| | - Tian-Bao Huang
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China
| | - Liang-Yong Zhu
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China
| | - Cheng-Hao Guo
- Clinical Medical College, Yangzhou University, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China
| |
Collapse
|
11
|
Kalkan S, Caliskan S. High D-dimer levels are associated with prostate cancer. Rev Assoc Med Bras (1992) 2020; 66:649-653. [DOI: 10.1590/1806-9282.66.5.649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 11/12/2019] [Indexed: 11/22/2022] Open
|
12
|
Huang GL, Kang CH, Lee WC, Chiang PH. Comparisons of cancer detection rate and complications between transrectal and transperineal prostate biopsy approaches - a single center preliminary study. BMC Urol 2019; 19:101. [PMID: 31660936 PMCID: PMC6816188 DOI: 10.1186/s12894-019-0539-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
Background Prostate biopsy remains the gold standard approach to verify prostate cancer diagnosis. Transrectal (TR) biopsy is a regular modality, while transperineal (TP) biopsy is an alternative for the patients who display persistently high levels of prostate-specific antigen (PSA) and thus have to undergo repeat biopsy. This study aimed to compare the cancer detection rates between TR and TP approaches and assess the post-bioptic complications of the two procedures. Besides, the feasibility of performing TP biopsies under local anesthesia was also evaluated. Methods A total of 238 outpatient visits meeting the criteria for prostate cancer biopsy were enrolled for this study. They were divided into two groups: the TP group (n = 130) consists of patients destined to undergo local anesthetic TP biopsy; and the TR group (n = 108) contained those who received TR biopsy as comparison. Age, PSA level, digital rectal exam (DRE) finding, prostate volume, and biopsy core number were used as the parameters of the multivariable analyses. The comparable items included cancer detection rate, complication rate, admission rate and visual analog scale (VAS) score. Results The cancer detection rates between TP and TR groups were quite comparable (45% v.s. 49%) (p = 0.492). However, the TP group, as compared to the TR group, had significantly lower incidence of infection-related complications (except epididymitis and prostatitis) that commonly occur after biopsies. None of the patients in the TP group were hospitalized due to the post-bioptic complications, whereas there was still a minor portion of those in the TR group (7.4%) requiring hospitalization after biopsy. Medians (25–75% quartiles) of visual analog scale (VAS) were 3 [3, 4] and 4 [3–5] respectively for the TP and TR procedures under local anesthesia, but no statistical significance existed between them (p = 0.085). Conclusions Patients receiving TP biopsy are less likely to manifest infection-related complications. Therefore, TP biopsy is a more feasible local anesthetic approach for prostate cancer detection if there are concerns for infectious complications and/or the risk of general anesthesia.
Collapse
Affiliation(s)
- Guan-Lin Huang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung, Taiwan, Republic of China
| | - Chih-Hsiung Kang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung, Taiwan, Republic of China
| | - Wei-Ching Lee
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung, Taiwan, Republic of China
| | - Po-Hui Chiang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung, Taiwan, Republic of China.
| |
Collapse
|
13
|
Bass EJ, Freeman A, Jameson C, Punwani S, Moore CM, Arya M, Emberton M, Ahmed HU. Prostate cancer diagnostic pathway: Is a one-stop cognitive MRI targeted biopsy service a realistic goal in everyday practice? A pilot cohort in a tertiary referral centre in the UK. BMJ Open 2018; 8:e024941. [PMID: 30361408 PMCID: PMC6224764 DOI: 10.1136/bmjopen-2018-024941] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/24/2018] [Accepted: 09/20/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility of a novel multiparametric MRI (mpMRI) and cognitive fusion transperineal targeted biopsy (MRTB) led prostate cancer (PCa) diagnostic service with regard to cancer detection and reducing time to diagnosis and treatment. DESIGN Consecutive men being investigated for possible PCa under the UK 2-week wait guidelines. SETTING Tertiary referral centre for PCa in the UK. PARTICIPANTS Men referred with a raised prostate-specific antigen (PSA) or abnormal digital rectal examination between February 2015 and March 2016 under the UK 2-week rule guideline. INTERVENTIONS An mpMRI was performed prior to patients attending clinic, on the same day. If required, MRTB was offered. Results were available within 48 hours and discussed at a specialist multidisciplinary team meeting. Patients returned for counselling within 7 days PRIMARY AND SECONDARY OUTCOME MEASURES: Outcome measures in this regard included the time to diagnosis and treatment of patients referred with a suspicion of PCa. Quality control outcome measures included clinically significant and total cancer detection rates. RESULTS 112 men were referred to the service. 111 (99.1%) underwent mpMRI. Median PSA was 9.4 ng/mL (IQR 5.6-21.0). 87 patients had a target on mpMRI with 25 scoring Likert 3/5 for likelihood of disease, 26 4/5 and 36 5/5.57 (51%) patients received a local anaesthetic, Magnetic resonance imaging targeted biopsy (MRTB). Cancer was detected in 45 (79%). 43 (96%) had University College London definition 2 disease or greater. The times to diagnosis and treatment were a median of 8 and 20 days, respectively. CONCLUSIONS This approach greatly reduces the time to diagnosis and treatment. Detection rates of significant cancer are high. Similar services may be valuable to patients with a potential diagnosis of PCa.
Collapse
Affiliation(s)
- Edward James Bass
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Alex Freeman
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Charles Jameson
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Shonit Punwani
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
- Division of Medicine, Centre for Medical Imaging, University College London, London, UK
| | - Caroline M Moore
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Manit Arya
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Hashim Uddin Ahmed
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
14
|
Wang Y, Zhu J, Qin Z, Wang Y, Chen C, Wang Y, Zhou X, Zhang Q, Meng X, Song N. Optimal biopsy strategy for prostate cancer detection by performing a Bayesian network meta-analysis of randomized controlled trials. J Cancer 2018; 9:2237-2248. [PMID: 30026819 PMCID: PMC6036722 DOI: 10.7150/jca.24690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/16/2018] [Indexed: 12/23/2022] Open
Abstract
Objective: With the increasing recognition of the over-diagnosis and over-treatment of prostate cancer (PCa), the choice of a better prostate biopsy strategy had confused both the patients and clinical surgeons. Hence, this network meta-analysis was conducted to clarify this question. Methods: In the current network meta-analysis, twenty eligible randomized controlled trials (RCTs) with 4,571 participants were comprehensively identified through Pubmed, Embase and Web of Science databases up to July 2017. The pooled odds ratio (OR) with 95% credible interval (CrI) was calculated by Markov chain Monte Carlo methods. A Bayesian network meta-analysis was conducted by using R-3.4.0 software with the help of package "gemtc" version 0.8.2. Results: Six different PCa biopsy strategies and four clinical outcomes were ultimately analyzed in this study. Although, the efficacy of different PCa biopsy strategies by ORs with corresponding 95% CrIs had not yet reached statistical differences, the cumulative rank probability indicated that overall PCa detection rate from best to worst was FUS-GB plus TRUS-GB, FUS-GB, CEUS, MRI-GB, TRUS-GB and TPUS-GB. In terms of clinically significant PCa detection, CEUS, FUS-GB or FUS-GB plus TRUS-GB had a higher, whereas TRUS-GB or TPUS-GB had a relatively lower significant detection rate. Meanwhile, TPUS-GB or TRUS-GB had a higher insignificant PCa detection rate. As for TRUS-guided biopsy, the general trend was that the more biopsy cores, the higher overall PCa detection rate. As for targeted biopsy, it could yield a comparable or even a better effect with fewer cores, compared with traditional random biopsy. Conclusion: Taken together, in a comprehensive consideration of four clinical outcomes, our outcomes shed light on that FUS-GB or FUS-GB plus TRUS-GB showed their superiority, compared with other puncture methods in the detection of PCa. Moreover, TPUS or TRUS-GB was more easily associated with the over-diagnosis and over-treatment of PCa. In addition, targeted biopsy was obviously more effective than traditional random biopsy. The subsequent RCTs with larger sample sizes were required to validate our findings.
Collapse
Affiliation(s)
- Yi Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jundong Zhu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.,Current affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, 213000, China
| | - Zhiqiang Qin
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yamin Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Chen Chen
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yichun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiang Zhou
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qijie Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xianghu Meng
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| |
Collapse
|
15
|
Meng Y, Cubillos J, Borch M, Messing EM, Gentile D, Joseph JV, Rashid H, Kukreja JB. Antibiogram Directed Prophylaxis for Transrectal Prostate Biopsy: An Application of Recommendations in the Setting of High Fluoroquinolone Escherichia coli Resistance. UROLOGY PRACTICE 2017. [DOI: 10.1016/j.urpr.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yifan Meng
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Jimena Cubillos
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| | - Marianne Borch
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| | - Edward M. Messing
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| | - David Gentile
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| | - Jean V. Joseph
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| | - Hani Rashid
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| | - Janet Baack Kukreja
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
- Department of Urology, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
16
|
Çalışkan S, Sungur M. Fibrinogen and D-dimer levels in prostate cancer: Preliminary results. Prostate Int 2017; 5:110-112. [PMID: 28828354 PMCID: PMC5551919 DOI: 10.1016/j.prnil.2017.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/22/2017] [Accepted: 05/12/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Prostate cancer is one of the most common malignancy in men. The main risk factors for coagulation activation and thrombosis are malignancy and older age. The thrombosis risk may be associated with increased level of coagulation markers such as fibrinogen and D-dimer. The aim of this study is evaluate the relationship between coagulation markers and prostate cancer. METHODS This prospective study includes the patients who underwent transrectal ultrasound guided prostate biopsy and prostate surgery was performed between January 2015 and January 2016. Plasma prostate specific antigen (PSA), free PSA (fPSA), percentage fPSA, D-dimer and fibrinogen levels were measured before the procedures. The patients were divided into two groups according to the pathology results. The patients with benign prostate hyperplasia were in group 1 and the patients with prostate cancer were in group 2. RESULTS There were 76 patients in the current study. There were 53 patients in group 1 and 23 patients in group 2. The mean age of the patients, PSA, fPSA, fibrinogen and D-dimer levels was 65.33 ± 7.47 years, 8.21 ± 4.59, 1.41 ± 0.74 ng/ml, 309.75 ± 80.46 mg/dl, 0.42 ± 0.39 ug/ml in group 1. In group 2; the mean age of the patients, PSA, fPSA, fibrinogen and D-dimer levels was 66.08 ± 6.7 years, 145.69 ± 509.35, 7.32 ± 15 ng/ml, 312.16 ± 69.48 mg/dl, 1.09 ± 2.11 ug/ml. The prostate biopsy and transurethral surgery were performed in 64(%84.21) and 12(%15.79) patients. CONCLUSION The present study demonstrated that plasma D-dimer level was higher in patients with prostate cancer. Further studies that include large number of patients are needed to define the relationship between prostate cancer and coagulation disorder.
Collapse
Affiliation(s)
- Selahattin Çalışkan
- Department of Urology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
| | - Mustafa Sungur
- Department of Urology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
| |
Collapse
|
17
|
Carneiro A, Sivaraman A, Sanchez-Salas R, Nunes-Silva I, Baghdadi M, Srougi V, di Trapani E, Uriburu Pizzaro F, Doizi S, Barret E, Rozet F, Galiano M, Cathelineau X. Higher number of transrectal ultrasound guided prostate biopsy cores is associated with higher blood loss and perioperative complications in robot assisted radical prostatectomy. Actas Urol Esp 2017; 41:155-161. [PMID: 27890493 DOI: 10.1016/j.acuro.2016.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 08/12/2016] [Accepted: 09/01/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The local inflammatory process after prostate biopsies can have a negative impact on functional outcomes of radical prostatectomy. There is no evidence in literature demonstrating its impact on radical prostatectomy. OBJECTIVES To evaluate the impact of the number of TRUS core biopsies in the surgical morbidity and rate of positive margin on robot assisted radical prostatectomy (RARP). MATERIAL AND METHODS A prospectively maintained database of 2,054 RARPs in a single institution. Patients were further grouped into 2 groups based on the number of TRUS biopsy cores (G1≤12 cores; G2>12 cores). Multivariable logistic regression model was applied to analyze the impact of number of cores on complications. RESULTS A total number of 1,042 patients in the group 1 (≤12 cores) and 1,012 patients in the group 2 (>12 cores) were included. The rate of perioperative complications increased with higher number of biopsies (G1 6.4 vs. G2 8.5%; P=.03), but high grade complication (Clavien 3-4) were similar (G1 1.4 vs. G2 2.2%; P=.16). Positive surgical margin rates were similar in both groups (G1 11.8 vs. 9.98%; P=.2). At the multivariable logistic regression analysis shown that G2 had a 39% (OR 0.645) higher rate to experience perioperative complications during RARP. CONCLUSION Higher number of TRUS biopsy cores (>12) is associated to higher blood loss and perioperative complications during RARP. Careful preoperative evaluation for those patients underwent multiple biopsies or saturation protocols is mandatory. Application of longer intervals (>6 weeks) between biopsy and surgery may be advisable to minimize potential risks of surgical complications in patients may benefit from RARP. Further studies are still necessary to confirm these results.
Collapse
|
18
|
Toner L, Bolton DM, Lawrentschuk N. Prevention of sepsis prior to prostate biopsy. Investig Clin Urol 2016; 57:94-9. [PMID: 26981590 PMCID: PMC4791668 DOI: 10.4111/icu.2016.57.2.94] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/26/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy. Materials and Methods A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria. Results Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel. Conclusions The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice.
Collapse
Affiliation(s)
- Liam Toner
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia
| | - Damien M Bolton
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia.; Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.; School of Cancer Medicine, La Trobe University, Melbourne, Australia
| |
Collapse
|
19
|
A Case of In-Bore Transperineal MRI-Guided Prostate Biopsy of a Patient with Ileal Pouch-Anal Anastomosis. Case Rep Urol 2015; 2015:676930. [PMID: 26844005 PMCID: PMC4710955 DOI: 10.1155/2015/676930] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/22/2015] [Indexed: 12/17/2022] Open
Abstract
Ulcerative colitis (UC) is an inflammatory disease that specifically affects the colon. Ulcerative colitis is primarily treated medically and refractory disease is treated with proctocolectomy and ileal pouch-anal anastomosis (IPAA). Gastroenterologists advise against digital rectal exams, pelvic radiation therapy, and transrectal ultrasound (TRUS) biopsies of the prostates of ileal pouch-anal anastomosis patients. Any form of pouch manipulation can lead to severe bleeding, inflammation, and pain. Urologists are therefore faced with the challenge of doing a prostate biopsy without a transrectal ultrasound. We report the rare case of a patient with an ileal pouch-anal anastomosis who underwent in-bore transperineal MRI-guided biopsy of the prostate.
Collapse
|