Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases
Article first published online: 3 APR 2014
© 2013 The Authors. BJU International © 2013 BJU International
Volume 114, Issue 1, pages 32–37, July 2014
How to Cite
Vyas, L., Acher, P., Kinsella, J., Challacombe, B., Chang, R. T.M., Sturch, P., Cahill, D., Chandra, A. and Popert, R. (2014), Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases. BJU International, 114: 32–37. doi: 10.1111/bju.12282
- Issue published online: 25 JUN 2014
- Article first published online: 3 APR 2014
- Accepted manuscript online: 13 JUN 2013 06:34AM EST
- transperineal biopsy;
- prostate cancer;
- active surveillance
- To describe a protocol for transperineal sector biopsies (TPSB) of the prostate and present the clinical experience of this technique in a UK population.
Patients and 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).
- 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.
- TPSB of the prostate has a role in defining disease previously missed or under-diagnosed by TRB. The procedure has low morbidity.