title: The Use of Transperineal Sector Biopsy as A First-Line Biopsy Strategy: A Multi-Institutional Analysis of Clinical Outcomes and Complications.
abstract: OBJECTIVE
  Systematic transrectal ultrasound biopsies have been the first-line biopsy strategy in men with suspected prostate cancer for over 30 years. Transperineal biopsy is an alternative approach but has been predominately reserved as a repeat biopsy strategy and not widely used as a first-line approach. This study evaluates the diagnostic and clinical outcomes of transperineal sector biopsy (TPSB) as a first-line biopsy strategy in the diagnosis and management of prostate cancer.
  
  
  METHODS
  A multi-institutional review of 402 consecutive patients who underwent primary transperineal sector biopsy. All patients had no prior history of prostate biopsy. TPSB was carried out as a day-case procedure under general or regional anaesthesia. The cancer detection rate, location and complications for all cases were evaluated.
  
  
  RESULTS
  Prostate cancer was identified in 249 patients (61.9%) and was comparably sited across anterior, middle and posterior sectors. The disease was clinically significant (Gleason 3+4 or &gt; 4mm maximum cancer length) in 187 patients (47%). Post biopsy urinary retention occurred in 6 patients (1.5%). Hematuria requiring overnight hospital admission occurred in 4 patients (1.0%). There were no cases of urosepsis.
  
  
  CONCLUSIONS
  As a primary diagnostic strategy, TPSB is a safe and effective technique with high cancer detection rates. It also offers an attractive compromise to more extensive transperineal protocols, which can be more time-consuming and associated with higher morbidity.&nbsp.
authors.affiliation: Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.. eldredevans@doctors.org.uk.
authors.forename: David
authors.initials: D
authors.lastname: Eldred-Evans
authors.affiliation: Division of Surgery and Interventional Sciences, University College London, UK.
authors.forename: Veeru
authors.initials: V
authors.lastname: Kasivisvanathan
authors.affiliation: Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
authors.forename: Fahd
authors.initials: F
authors.lastname: Khan
authors.affiliation: Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
authors.forename: Mieke Van
authors.initials: MV
authors.lastname: Hemelrijck
authors.affiliation: Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Polson
authors.affiliation: Department of Urology, Southend University Hospital, Essex, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Acher
authors.affiliation: Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Popert
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011471:Prostatic Neoplasms / Q000473:pathology*; D016896:Treatment Outcome