Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases.
OBJECTIVE
To describe a protocol for transperineal sector biopsies (TPSB) of the prostate and present the clinical experience of this technique in a UK population.


METHODS
A retrospective review of a single-centre experience of TPSB approach was undertaken that preferentially, but not exclusively, targeted the peripheral zone of the prostate with 24-38 cores using a 'sector plan'. Procedures were carried out under general anaesthetic in most patients. Between January 2007 and August 2011, 634 consecutive patients underwent TPSB for the following indications: prior negative transrectal biopsy (TRB; 174 men); primary biopsy in men at risk of sepsis (153); further evaluation after low-risk disease diagnosed based on a 12-core TRB (307).


RESULTS
Prostate cancer was found in 36% of men after a negative TRB; 17% of these had disease solely in anterior sectors. As a primary diagnostic strategy, prostate cancer was diagnosed in 54% of men (median PSA level was 7.4 ng/mL). Of men with Gleason 3+3 disease on TRB, 29% were upgraded and went on to have radical treatment. Postoperative urinary retention occurred in 11 (1.7%) men, two secondary to clots. Per-urethral bleeding requiring hospital stay occurred in two men. There were no cases of urosepsis.


CONCLUSIONS
TPSB of the prostate has a role in defining disease previously missed or under-diagnosed by TRB. The procedure has low morbidity.
The Urology Centre, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Lona
L
Vyas
Peter
P
Acher
Janette
J
Kinsella
Ben
B
Challacombe
Richard T M
RT
Chang
Paul
P
Sturch
Declan
D
Cahill
Ashish
A
Chandra
Richard
R
Popert
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom
D017430:Prostate-Specific Antigen
active surveillance; biopsy; complications; prostate cancer; staging; transperineal biopsy