Infection rate and complications after 621 transperineal MRI-TRUS fusion biopsies in local anesthesia without standard antibiotic prophylaxis.
Aged
Anesthesia, Local
Antibiotic Prophylaxis
/ methods
Endosonography
Humans
Image-Guided Biopsy
/ methods
Magnetic Resonance Imaging
Male
Middle Aged
Multiparametric Magnetic Resonance Imaging
Perineum
Prostate
/ pathology
Prostate-Specific Antigen
/ blood
Prostatic Neoplasms
/ blood
Retrospective Studies
Sepsis
/ epidemiology
Surgical Wound Infection
/ epidemiology
Urinary Tract Infections
/ epidemiology
Antibiotic prophylaxis
Fusion biopsy
Local anesthesia
Prostate
Transperineal biopsy
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
25
01
2021
accepted:
10
04
2021
pubmed:
19
4
2021
medline:
19
2
2022
entrez:
18
4
2021
Statut:
ppublish
Résumé
The aim of this study was to assess the post biopsy infection rate, feasibility and prostate cancer (PCa) detection rate (CDR) by performing transperineal MRI-TRUS fusion biopsy of the prostate (TPBx) under local anesthesia (LA) without antibiotic prophylaxis (AP). We prospectively screened 766 men with suspicious lesions on mpMRI, an elevated PSA level or a suspect digital examination undergoing MRI-TRUS-TPBx in LA, from May 2019 to July 2020. Patients with the need for antibiotic prophylaxis or without a PI-RADS target lesion were excluded from final analyses. We reported CDR, perioperative pain (0-10) and postoperative complications. PCa with an ISUP grade ≥ 2 was classified as clinically significant PCa (csPCa). We included 621 patients with a median age of 68 years (IQR 62-74), a PSA of 6.43 ng/mL (IQR 4.72-9.91) and a prostate volume of 45 cc (IQR 32-64). In median, 4 targeted (TB) (IQR 3-4) and 6 (IQR 5-7) systematic biopsies (SB) detected in combination overall 416 (67%) PCa and 324 (52%) csPCa. Overall CDR of TB for PI-RADS 3, 4 and 5 was 26%, 65% and 84%, respectively. Patients reported a median perioperative pain level of 2 (IQR 1-3). Four patients (0.6%) developed a post biopsy infection, one experienced urosepsis. Our results demonstrate that transperineal MRI-TRUS fusion-guided prostate biopsy under LA without AP is feasible, safe and well tolerated.
Identifiants
pubmed: 33866401
doi: 10.1007/s00345-021-03699-1
pii: 10.1007/s00345-021-03699-1
doi:
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
3861-3866Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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