Transperineal Prostate Biopsy under Local Anesthesia: The 'Double-Freehand' Technique

What is it about?

The study describes a technique for double-freehand transperineal magnetic resonance imaging/transrectal ultrasound fusion prostate biopsy under local anesthesia. The technique was accurate and well-tolerated by patients, with a detection rate of 52% for prostate cancer and 81% for clinically significant prostate cancer. The complication rate was 2.1%, with no sepsis, rectal bleeding, or urinary retention. The study was conducted on 96 patients who met the inclusion criteria, and the median age was 68 years, with a PSA level of 7.84 ng/mL, a prostate volume of 56 mL, and a maximum cancer core length of 11 mm. The technique was demonstrated to be accurate, safe, and cost-effective, and it can be used to address the limitations of transperineal prostate biopsy.

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Photo by Afif Ramdhasuma on Unsplash

Photo by Afif Ramdhasuma on Unsplash

Why is it important?

This research is important as it describes a new technique for transperineal prostate biopsy (TP PBx) under local anesthesia (LA), which is a safer alternative to transrectal prostate biopsy (TRUS-guided PBx). The technique, called "double-freehand TP MRI/TRUS fusion PBx under LA," is accurate and well-tolerated by patients, and it simplifies, streamlines, and reduces the cost of TP PBx. The study reports outcomes of a self-taught urologist transitioning from TRUS-guided PBx to TP PBx approach and provides a step-by-step video demonstration of the technique. Key Takeaways: 1. The double-freehand technique of TP MRI/TRUS fusion PBx under LA is accurate and well-tolerated by patients. 2. The technique simplifies, streamlines, and reduces the cost of TP PBx. 3. The study reports outcomes of a self-taught urologist transitioning from TRUS-guided PBx to TP PBx approach. 4. The technique is cost-effective and requires no additional device or equipment/supply. 5. The main disadvantage of the technique is that it requires manual alignment of the probe and biopsy needle axis.