Trans-rectal versus trans-perineal saturation rebiopsy of the prostate: is there a difference in cancer detection rate?
OBJECTIVE
To test the hypothesis that there is no significant difference in the rate of prostate cancer (PCa) detection rate between the transrectal and transperineal approach in men undergoing a saturation (24-core) prostate rebiopsy.


METHODS
We evaluated 472 consecutive men who underwent a 24-core prostate rebiopsy at 2 tertiary referral centers. Of these, 70% (332) underwent a transrectal biopsy, and 30% (140) underwent a transperineal biopsy. Propensity score was used to match 280 patients with homogeneous characteristics; those represented the final study cohort. Univariable and multivariable logistic regression analyses were used to address the relationship between biopsy approach and PCa detection rate. Covariates consisted of age at biopsy, prostate-specific antigen, total prostate volume, digital rectal examination findings, histologic findings on previous biopsy, and the number of previous negative biopsy sets.


RESULTS
Overall, PCa detection rate was 28.6%. There was no statistically significant difference in PCa detection rate between the transrectal and transperineal approach (31.4% vs 25.7%, respectively; P = .3). The type of approach was not an independent predictor of PCa detection rate at multivariable analyses (odds ratio = 0.61, P = .1).


CONCLUSIONS
Transrectal and transperineal prostate saturation biopsies have a similar PCa detection rate in men undergoing a saturation rebiopsy. Both approaches can be offered to men undergoing a prostate rebiopsy without undermining the rate of PCa detection.
University Vita-Salute/San Raffaele Hospital, Milan, Italy. firas.abdollah@gmail.com
Firas
F
Abdollah
Giacomo
G
Novara
Alberto
A
Briganti
Vincenzo
V
Scattoni
Marco
M
Raber
Marco
M
Roscigno
Nazareno
N
Suardi
Andrea
A
Gallina
Walter
W
Artibani
Vincenzo
V
Ficarra
Andrea
A
Cestari
Giorgio
G
Guazzoni
Patrizio
P
Rigatti
Francesco
F
Montorsi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010502:Perineum; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012007:Rectum