title: Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated: a prospective study using patient-reported outcome measures.
abstract: We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 (21.4%) of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy (with 95% scoring <5 in a 0-10 scale). Twelve out of 196 men (6.1%) felt pain immediately after the procedure. Despite a high incidence of symptoms (e.g., up to 75% had some hematuria, 47% suffered some pain), it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization (5.5%). There were no inpatient admissions due to complications (hematuria, sepsis). On repeat questioning at a later time point, only 25/199 (12.6%) of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.
authors.forename: Karan
authors.initials: K
authors.lastname: Wadhwa
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.
authors.forename: Lina
authors.initials: L
authors.lastname: Carmona-Echeveria
authors.affiliation: Department of Urology, University Hospital Heidelberg, Germany.
authors.forename: Timur
authors.initials: T
authors.lastname: Kuru
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Gaziev
authors.affiliation: Department of Biochemistry, University of Cambridge, Cambridge, UK.
authors.forename: Eva
authors.initials: E
authors.lastname: Serrao
authors.affiliation: Cancer Research Centre and Statistics and Epidemiology Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Deepak
authors.initials: D
authors.lastname: Parashar
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Frey
authors.affiliation: Department of Urology, University Hospital Heidelberg, Germany.
authors.forename: Ivailo
authors.initials: I
authors.lastname: Dimov
authors.affiliation: Department of Urology, University Hospital Heidelberg, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Seidenader
authors.affiliation: Department of Urology, Southend University Hospital, Southend, UK.
authors.forename: Pete
authors.initials: P
authors.lastname: Acher
authors.affiliation: Department of Urology, Kings College Hospital, London, UK.
authors.forename: Gordon
authors.initials: G
authors.lastname: Muir
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.|CamPARI Prostate Cancer Clinic, Addenbrookes Hospital, Cambridge UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Doble
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.|CamPARI Prostate Cancer Clinic, Addenbrookes Hospital, Cambridge UK.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gnanapragasam
authors.affiliation: Department of Urology, University Hospital Heidelberg, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Hadaschik
authors.affiliation: Department of Urology, Addenbrookes Hospital, Cambridge, UK.|CamPARI Prostate Cancer Clinic, Addenbrookes Hospital, Cambridge UK.
authors.forename: Christof
authors.initials: C
authors.lastname: Kastner
mesh_terms: D000368:Aged; D000772:Anesthesia, Local; D001294:Attitude to Health; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D015331:Cohort Studies; D004244:Dizziness / Q000453:epidemiology; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D000071066:Patient Reported Outcome Measures; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D011795:Surveys and Questionnaires; D013575:Syncope / Q000453:epidemiology