Morbidity of Transrectal MRI-Fusion Targeted Prostate Biopsy at a Tertiary Referral Academic Centre: An Audit to Guide the Transition to the Transperineal Approach

Despite transrectal prostate biopsy (TRPB) being still widespread globally, the EAU Guidelines strongly recommend the transperineal approach, due to the reported lower infectious risk. Our study aims to evaluate the impact of a standardized clinical pathway for TRPB on post-operative complications....

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Published in:Cancers 2023-12, Vol.15 (24), p.5798
Main Authors: Alberti, Andrea, Nicoletti, Rossella, Polverino, Paolo, Rivetti, Anna, Dibilio, Edoardo, Resta, Giulio Raffaele, Makrides, Pantelis, Caneschi, Corso, Cifarelli, Andrea, D'Amico, Antonino, Moscardi, Luisa, Lo Re, Mattia, Peschiera, Federico, Gallo, Maria Lucia, Pecoraro, Alessio, Sebastianelli, Arcangelo, Masieri, Lorenzo, Gacci, Mauro, Serni, Sergio, Campi, Riccardo, Sessa, Francesco
Format: Article
Language:English
Subjects:
Adverse events
Antibiotics
Biopsy
Cartography
Complications
Decision making
Disease prevention
E coli
Health aspects
Hematuria
Infection
Iodine
Magnetic resonance imaging
Morbidity
Patient care planning
Patient education
Postoperative
Prostate
Sepsis
Software
Ultrasonic imaging
Urinary tract
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Summary:Despite transrectal prostate biopsy (TRPB) being still widespread globally, the EAU Guidelines strongly recommend the transperineal approach, due to the reported lower infectious risk. Our study aims to evaluate the impact of a standardized clinical pathway for TRPB on post-operative complications. We prospectively collected data from all patients undergoing mpMRI-targeted TRPB at our Academic Centre from January 2020 to December 2022. All patients followed a standardized, structured multistep pathway. Post-procedural complications were collected and classified according to the Clavien-Dindo (CD) Classification. Among 458 patients, post-procedural adverse events were reported by 203 (44.3%), of which 161 (35.2%) experienced CD grade 1 complications (hematuria [124, 27.1%], hematochezia [22, 4.8%], hematospermia [14, 3.1%], or a combination [20, 4.4%]), and 45 (9.0%) reported CD grade 2 complications (acute urinary retention or hematuria needing catheterization, as well as urinary tract infections, of which 2 cases required hospitalization). No major complications, including sepsis, were observed. At uni- and multivariable analysis, age > 70 years and BMI > 25 kg/ m for patients were identified as predictors of post-operative complications. The results of our study confirm that TRPB is a safe and cost-effective procedure with a low risk of severe adverse events in experienced hands and following a standardized pathway.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15245798