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Transperineal Ultrasound Guided-Template Biopsy of Prostate as First Means of Diagnosis of Prostate Cancer One single centre experience on 405 cases


Even if today�s standard procedure for diagnosis of prostate cancer is transrectal ultrasound guided prostate biopsy ( TRB), transperineal ultrasound -guided template biopsy (TPTB) is a safe procedure because the infectious complication have been increasing, with a detection ratio even better than TRB. We consider that TPTB can be the gold standard biopsy. To assess the efficiency and safety of transperineal ultrasound-guided template biopsy of prostate (TPTB). We studied prospectively a number of 405 patients who underwent TPTB of prostate as first means of diagnosis from September 2015 to August 2017.The procedure was performed in the surgery room, in lithotomy positon, under local anesthesia, by means of standard freehand method sampling of at least 12 fragments,based on predetermined mapping. The data base included the age of the patient, the PSA level, the prostatic volume, the presence of clinical suspicion at digital rectal examination, the histopathological data and immediate and late post-surgery complications. Prostate cancer was diagnosed in 68.6 % of men ( median PSA level was 11 ng/mL). A higher detection ratio within patients with prostate volume [ 60 mL can be noticed.The average Gleason score was of 7.6. No patient developed any feverish symptom or urosepsis. Given the increasing trend of sepsis ratio as a result of transrectal biopsy of prostate, as well as the increased ratio of antibiotic resistance, we appreciate that the benefit of transperineal approach is important enough in order to perform TPTB as first means as well as routine for all patients. In this report we looked to assess the efficiency and the safety of TPTB as first mean of diagnosis. None of the patients had a previous biopsy by transrectal or transperineal method.
