title: Current practice of prostate biopsy in Australia and New Zealand: A survey.
abstract: BACKGROUND
  Prostate biopsy remains the gold standard for prostate cancer diagnosis. The field of prostate biopsy is undergoing a rapid change. This study aims to provide a snapshot of the current practice of prostate biopsy in the Urological Society of Australia and New Zealand (USANZ).
  
  
  METHODS
  A 31-question multiple-choice survey was constructed using a web-based provider and was distributed to 644 members of USANZ. The questionnaire addressed various aspects of prostate biopsy. Questionnaire results were collated and the data were analyzed statistically.
  
  
  RESULTS
  150 completed surveys were returned, with a response rate of 23.3%: 84.5% of those completing the survey were consultant urologists and 68% were working in a metropolitan setting. 98.6% of clinicians used prophylactic antibiotics before prostate biopsy, most commonly a quinolone. 30.6% had used intravenous (IV) carbapenems at least once. Peri-prostatic local anesthetic (LA) infiltration was used by 39.9% of clinicians with 73% using IV sedation or general anesthetic (GA). 38.4% of clinicians reported performing TPT biopsy of the prostate and 19.6% of clinicians had ordered a MRI of the prostate prior to an initial biopsy with 10.2% routinely ordering a MRI of the prostate before repeat biopsy.
  
  
  CONCLUSIONS
  Frequent prophylactic use of carbapenems suggests concern amongst clinicians about sepsis with quinolone-resistant bacteria. Almost 75% of TRUS biopsies were performed under IV sedation or GA indicating a heavy demand of health resources. TPT biopsy was used commonly and there was significant use of multiparametric MRI prior to prostate biopsy.
authors.affiliation: Department of Urology, Alfred Health, Monash University, Melbourne, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Davis
authors.affiliation: Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
authors.forename: Eldho
authors.initials: E
authors.lastname: Paul
authors.affiliation: Department of Urology, Alfred Health, Monash University, Melbourne, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Grummet
keywords: Antibiotics; magnetic resonance; prostate biopsy; prostate cancer; transperineal template biopsy; transrectal ultrasound-guided biopsy