The following is a summary of “Transperineal vs. transrectal prostate biopsies under local anesthesia: A prospective cohort study on patient tolerability and complication rates,” published in the September 2023 issue of Urologic Oncology: Seminars and Original Investigations by Berquin, et al.

Urologists are shifting their practice of diagnosing prostate cancer from transrectal (TR) to transperineal (TP) biopsies. When considering patient care, potential dangers, and financial implications, a local anesthetic (LA) may prove preferable. Researchers study’s primary objective was to assess the safety and efficacy of LA-facilitated transperineal prostate biopsy. This study is a prospective, comparative, observational cohort study with a single center. The Researchers enrolled 128 patients (TR, n = 61; TP, n = 67) with a history or suspicion of prostate cancer between July 2020 and July 2021. LA was used for both transrectal and transperineal prostate biopsies.

Researchers provided a validated visual analog pain score (VAS) at pre-procedural, intra-procedural, and post-procedural times (12, 24, and 48 hours) to assess tolerance. Patients were given the International Prostate Symptom Score (IPSS) questionnaire before and after the surgery. Acute retention, fever, and a urinary tract infection (UTI) were also tracked. The IPSS and pain scores were similar among groups, except for a substantially greater pain score in the TP group during prostate LA.

The incidence of complications was comparable across the two groups, except hematuria, which was more common in the TP group 24 hours after the surgery, and rectal bleeding, which was more common in the TR group 12 hours after the treatment. Our results demonstrated that transperineal prostate biopsy under local anesthetic is feasible and has comparable pain scores and complication rates to transrectal biopsy.

Source: sciencedirect.com/science/article/abs/pii/S1078143923001953