Morbidity following transperineal prostate biopsy: Our experience in 8.500 men

Submitted: April 25, 2022
Accepted: April 30, 2022
Published: June 29, 2022
Abstract Views: 1193
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Introduction: To evaluate clinical complications following transperineal prostate biopsy in 8.500 patients. Materials and methods: From January 2000 to January 2022, 8,500 men (median age: 62.8 years) underwent transperineal prostate biopsy; since 2011, 1,850 patients were submitted to mpMRI and in the presence of a PI-RADS score ≥ 3, a transperineal targeted biopsy was added to systematic prostate biopsy (4 cores). All patients underwent antibiotic prophylaxis (2000-2011: levoxacin 500 tablet; 2012-2022: 2 grams intravenous of cefazolin). Among 8.500 men 1.350 (15.8%) vs. 4.520 (53.3%) vs. 2.630 (30.9%) underwent 12 vs. 18 vs. > 24 needle cores, respectively. The prostate biopsy-related complications were evaluated within 20 days from prostate biopsy; the number of patients who needed hospital admission or emergency department visit (EDV) was recorded. Results: Prostate cancer was found in 3.150/8.500 (37.1%) patients; overall, hospital admission and EDV were equal to 1.5% and 8.9% and the side effects were directly correlated with the number of needle cores resulting equal to 17.4% (12 cores), 38.7% (18 cores) and 55.3% (> 24 cores) (p = 0.001). Hospital admission and EDV in men who underwent 12 vs. 18 vs. > 24 cores occurred in 1.5% and 7.4% vs. 1.4% and 8.7% vs. 1.7% and 10.6% (p > 0.05), respectively. Conclusions: Clinical complications following transperineal prostate biopsy involved 35.9% of the patients but only 1.5% of them required hospital admission; urinary tract infection with fever was the most frequent cause of hospital recovery (33.4% of the cases), but none of the patients developed sepsis.

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Lenfant L, Barret E, Rouprêt M, et al. Transperineal prostate biopsy is the new black: what are the next targets? Cancerology Committee of Association Française d'Urologie (CCAFU). Eur Urol. 2022; S0302-2838(22)01602-5.
Mottet N, Cornford P, van den Bergh RCN. Guidelines Associates. EAU guideline. 2022. Prostate cancer.
Mehmood S, Alothman KI, Alwehaibi A, Alhashim SM. Diagnostic efficacy and safety of transperineal prostate targeted and systematic biopsy: The preliminary experience of first 100 cases. Arch Ital Urol Androl. 2021; 93:127-131. DOI: https://doi.org/10.4081/aiua.2021.2.127
Derin O, Fonseca L, Sanchez-Salas R, Roberts MJ. Infectious complications of prostate biopsy: winning battles but not war. World J Urol. 2020; 38:2743-2753. DOI: https://doi.org/10.1007/s00345-020-03112-3
He J, Guo Z, Huang Y, et al. Comparisons of efficacy and complications between transrectal and transperineal prostate biopsy with or without antibiotic prophylaxis Urol Oncol 2022; S1078-1439(22)00004-7.
Pinkhasov GI, Lin YK, Palmerola R, et al. Complications following prostate needle biopsy requiring or emergency department visitsexperience from 1000 consecutive cases. BJU Int. 2012; 110:369-374. DOI: https://doi.org/10.1111/j.1464-410X.2011.10926.x
Meyer AR, Mamawala M, Winoker JS, et al. Transperineal prostate biopsy improves the detection of clinically significant prostate cancer among men on active surveillance J Urol. 2021; 205:1069-1074. DOI: https://doi.org/10.1097/JU.0000000000001523
Pepe P, Aragona F. Prostate biopsy: results and advantages of the transperineal approach--twenty-year experience of a single center. World J Urol. 2014; 32:373-377. DOI: https://doi.org/10.1007/s00345-013-1108-1
Pepe P, Garufi A, Priolo GD, et al. Is it time to perform only MRI targeted biopsy? Our experience in 1032 men submitted to prostate biopsy. J Urol. 2018; 200:774-778. DOI: https://doi.org/10.1016/j.juro.2018.04.061
Pepe P, Aragona F. Saturation prostate needle biopsy and prostate cancer detection at initial and repeat evaluation. Urology. 2007; 70:1131-1135. DOI: https://doi.org/10.1016/j.urology.2007.07.068
Moore CM, Kasivisvanathan V, Eggener S, et al. Standards of Reporting for MRI-targeted Biopsy Studies (START) of the Prostate: Recommendations from an International Working Group. Eur Urol. 2013; 64:544-552. DOI: https://doi.org/10.1016/j.eururo.2013.03.030
Pepe P, Pennisi M, Fraggetta F. How many cores should be obtained during saturation biopsy in the ra of multiparametric magnetic resonance? Experience in 875 patients submitted to repeat prostate biopsy. Urology. 2020; 137:133-137. DOI: https://doi.org/10.1016/j.urology.2019.11.016
Pepe P, M Pennisi. Erectile dysfunction in 1050 men following extended (18 cores) vs saturation (28 cores) vs saturation plus MRItargeted prostate biopsy (32 cores). Int J Impot Res. 2016; 28:1-3. DOI: https://doi.org/10.1038/ijir.2015.18
Valerio M, Anele C, Bott SR, et al. The prevalence of clinically significant prostate cancer according to commonly used histological thresholds in men undergoing template prostate mapping bopsies. J Urol. 2016; 195:1403-1408. DOI: https://doi.org/10.1016/j.juro.2015.11.047
Dindo D, Demartines N and Clavien PA. Classification of surgical complications. A new proposal with evaluation in a Cohort of 6336 patients and results of survey. Ann Surg. 2004; 2:205-213. DOI: https://doi.org/10.1097/01.sla.0000133083.54934.ae
Tan WP, Papagiannopoulos D, Latchamsetty KC, et al. Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy. Prostate Cancer Prostatic Dis. 2019; 22:350. DOI: https://doi.org/10.1038/s41391-019-0133-6
Papagiannopoulos D, Abern M, Wilson N, et al. Predictors of Infectious Complications after Targeted Prophylaxis for Prostate Needle Biopsy. J Urol. 2018; 199:155-160. DOI: https://doi.org/10.1016/j.juro.2017.08.040
Loeb S, Vellekoop A, Ahmed HU, et al. Systematic review of complications of prostate biopsy. Eur Urol. 2013; 64:876-892. DOI: https://doi.org/10.1016/j.eururo.2013.05.049
Carignan A, Roussy JF, Lapointe V, et al. Increasing risk of infectious complications after transrectal ultrasound-guided biopsies: time to reassess antimicrobial prophylaxis? Eur Urol. 2012; 62:453-459. DOI: https://doi.org/10.1016/j.eururo.2012.04.044
Nam RK, Saskin R, Lee Y, et al. Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol. 2010; 183:963-969. DOI: https://doi.org/10.1016/j.juro.2009.11.043
Loeb S, van den Heuvel S, Zhu X, et al. Infectious complications and hospital admissions after prostate biopsy in a European randomized trial. Eur Urol. 2012; 61:1110-1114. DOI: https://doi.org/10.1016/j.eururo.2011.12.058
Pilatz A, Veeratterapillay R, Köves B, et al. Update on strategies to reduce infectious complications after prostate biopsy. Eur Urol Focus. 2019; 5:20-28. DOI: https://doi.org/10.1016/j.euf.2018.11.009
Dai J, Leone A, Mermel L, Hwang K, et al. Rectal swab culturedirected antimicrobial prophylaxis for prostate biopsy and risk of postprocedure infection: a cohort study. Urology. 2015; 85:8-14. DOI: https://doi.org/10.1016/j.urology.2014.09.035
Pepe P, Aragona F. Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology. 2013; 81:1142-1146. DOI: https://doi.org/10.1016/j.urology.2013.02.019
Berry B, Parry MG, Sujenthiran A, et al. Comparison of complications after transrectal and transperineal prostate biopsy: a national population-based study. BJU Int. 2020; 126:97-103. DOI: https://doi.org/10.1111/bju.15039
Miller J, Perumalla C, Heap G. Complications of transrectal versus transperineal prostate biopsy. ANZ J Surg. 2005; 75:48-50. DOI: https://doi.org/10.1111/j.1445-2197.2005.03284.x
Pradere B, Veeratterapillay R, Dimitropoulos K, et al. Nonantibiotic strategies for the prevention of infectious complications following prostate biopsy: a systematic review and meta-analysis. J Urol. 2021; 205:653-663. DOI: https://doi.org/10.1097/JU.0000000000001399
Basourakos SP, Alshak MN, Lewicki PJ, et al. Role of prophylactic antibiotics in transperineal prostate biopsy: a systematic review and meta-analysis. Eur Urol Open Sci. 2022; 37:53-63. DOI: https://doi.org/10.1016/j.euros.2022.01.001
Stefanova V, Buckley R, Flax S, et al. Transperineal prostate biopsies using local anesthesia: experience with 1,287 patients. Prostate cancer detection rate, complications and patient tolerability. J Urol. 2019; 201:1121-1126. DOI: https://doi.org/10.1097/JU.0000000000000156
Cricco-Lizza E, Wilcox Vanden Berg RN, Laviana A, et al. Comparative effectiveness and tolerability of transperineal MRI-targeted prostate biopsy under local versus sedation. Urology. 2021; 155:33-38. DOI: https://doi.org/10.1016/j.urology.2021.06.023

How to Cite

Pepe, P., & Pennisi, M. (2022). Morbidity following transperineal prostate biopsy: Our experience in 8.500 men. Archivio Italiano Di Urologia E Andrologia, 94(2), 155–159. https://doi.org/10.4081/aiua.2022.2.155