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      Pooled outcomes of performing freehand transperineal prostate biopsy with the PrecisionPoint Transperineal Access System

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          Abstract

          Objectives

          To report the results of a pooled analysis evaluating the cancer detection rates, complications, and tolerability of prostate biopsies performed using the PrecisionPoint Transperineal Access System.

          Patients and Methods

          The medical literature was reviewed to identify studies published prior to 1 October 2021 evaluating the PrecisionPoint device for performance of transperineal prostate biopsy. Pooled analyses were performed to assess overall and clinically significant cancer detection rates. Additionally, data on complications as well as patient tolerability of the procedure when performed under local anaesthesia were extracted.

          Results

          Transperineal biopsy with the PrecisionPoint Transperineal Access System achieved overall and clinically significant cancer detection rates of 67.9% and 42.6%, respectively. Among patients with Prostate Imaging Reporting and Data System 3, 4, and 5 lesions on prostate magnetic resonance imaging, clinically significant disease was found in 31.7%, 55.7%, and 71.8% of patients, respectively. Complications were rare, with sepsis reported in 4 (0.1%) of 3411 procedures despite frequent omission of antibiotic prophylaxis. Patients reported acceptable tolerability of the procedure when performed under local anaesthesia.

          Conclusions

          Within the available medical literature, there is uniform evidence supporting the use of the PrecisionPoint Transperineal Access System for performing prostate biopsy procedures. The reported cancer detection and infectious complication rates with this device are in line with other methods for performing transperineal prostate biopsy. A unique aspect of the PrecisionPoint device is its ability to facilitate performing transperineal prostate biopsy under local anaesthesia. This factor will likely lead to increased adoption of the beneficial transperineal approach to prostate biopsy.

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          Most cited references41

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          Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study

          Men with high serum prostate specific antigen usually undergo transrectal ultrasound-guided prostate biopsy (TRUS-biopsy). TRUS-biopsy can cause side-effects including bleeding, pain, and infection. Multi-parametric magnetic resonance imaging (MP-MRI) used as a triage test might allow men to avoid unnecessary TRUS-biopsy and improve diagnostic accuracy.
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            Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer: a systematic review and meta-analysis

            Background Because conventional prostate biopsy has some limitations, optimal variations of prostate biopsy strategies have emerged to improve the diagnosis rate of prostate cancer. We conducted the systematic review to compare the diagnosis rate and complications of transperineal versus transrectal prostate biopsy. Main body of the abstract We searched for online publications published through June 27, 2018, in PubMed, Scopus, Web of Science, and Chinese National Knowledge Infrastructure databases. The relative risk and 95% confidence interval were utilized to appraise the diagnosis and complication rate. The condensed relative risk of 11 included studies indicated that transperineal prostate biopsy has the same diagnosis accuracy of transrectal prostate biopsy; however, a significantly lower risk of fever and rectal bleeding was reported for transperineal prostate biopsy. No clue of publication bias could be identified. Short conclusion To conclude, this review indicated that transperineal and transrectal prostate biopsy have the same diagnosis accuracy, but the transperineal approach has a lower risk of fever and rectal bleeding. More studies are warranted to confirm these findings and discover a more effective diagnosis method for prostate cancer. Electronic supplementary material The online version of this article (10.1186/s12957-019-1573-0) contains supplementary material, which is available to authorized users.
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              Transperineal Prostate Biopsies Using Local Anesthesia: Experience with 1,287 Patients. Prostate Cancer Detection Rate, Complications and Patient Tolerability

              We report our experience with transperineal prostate biopsy as well as the cancer diagnosis rate, complications and patient tolerability in 1,287 consecutive patients at risk for prostate cancer.
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                Author and article information

                Contributors
                mgorin@urologyassociatesmd.com
                Journal
                BJUI Compass
                BJUI Compass
                10.1002/(ISSN)2688-4526
                BCO2
                BJUI Compass
                John Wiley and Sons Inc. (Hoboken )
                2688-4526
                28 June 2022
                November 2022
                : 3
                : 6 ( doiID: 10.1002/bco2.v3.6 )
                : 434-442
                Affiliations
                [ 1 ] Department of Urology Weill Cornell Medicine New York New York USA
                [ 2 ] Department of Urology Loyola University Medical Center Maywood Illinois USA
                [ 3 ] Urology Associates and UPMC Western Maryland Cumberland Maryland USA
                [ 4 ] Department of Urology University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
                Author notes
                [*] [* ] Correspondence

                Michael A. Gorin, Urology Associates and UPMC Western Maryland, 12234 Williams Road, Cumberland, MD 21502, USA.

                Email: mgorin@ 123456urologyassociatesmd.com

                Author information
                https://orcid.org/0000-0003-1384-407X
                https://orcid.org/0000-0003-4028-010X
                https://orcid.org/0000-0002-8315-6603
                Article
                BCO2178
                10.1002/bco2.178
                9579885
                36267202
                00372e0c-27fc-4bb3-8067-4c503255ca2b
                © 2022 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 May 2022
                : 10 March 2022
                : 12 June 2022
                Page count
                Figures: 2, Tables: 2, Pages: 9, Words: 6414
                Funding
                Funded by: Prostate Cancer Challenge Award
                Funded by: Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust
                Award ID: NIH R01‐CA241758
                Award ID: NIH R01‐CA259173
                Award ID: PCORI CER‐2019C1‐15682
                Award ID: PCORI CER‐2019C2‐17372
                Categories
                Review
                To the Journals
                Custom metadata
                2.0
                November 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:19.10.2022

                biopsy,diagnostic techniques,surgical,precisionpoint,prostatic neoplasms,sepsis,transperineal

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