MP49-05 RISK OF POST-BIOPSY PROSTATITIS AMONG PATIENTS UNDERGOING TRANSRECTAL AND TRANSPERINEAL MRI/US FUSION PROSTATE BIOPSY

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP49)1 May 2024MP49-05 RISK OF POST-BIOPSY PROSTATITIS AMONG PATIENTS UNDERGOING TRANSRECTAL AND TRANSPERINEAL MRI/US FUSION PROSTATE BIOPSY Hiroki Tanaka, Masaki Kobayashi, Kasumi Yoshitomi, Bo Fan, Motohiro Fujiwara, Yuki Nakamura, Yudai Ishikawa, Shohei Fukuda, Yuma Waseda, Hajime Tanaka, Soichiro Yoshida, and Yasuhisa Fujii Hiroki TanakaHiroki Tanaka , Masaki KobayashiMasaki Kobayashi , Kasumi YoshitomiKasumi Yoshitomi , Bo FanBo Fan , Motohiro FujiwaraMotohiro Fujiwara , Yuki NakamuraYuki Nakamura , Yudai IshikawaYudai Ishikawa , Shohei FukudaShohei Fukuda , Yuma WasedaYuma Waseda , Hajime TanakaHajime Tanaka , Soichiro YoshidaSoichiro Yoshida , and Yasuhisa FujiiYasuhisa Fujii View All Author Informationhttps://doi.org/10.1097/01.JU.0001008696.31772.28.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prior studies have indicated fewer post-biopsy infectious complications with transperineal (TP) approach compared to transrectal (TR) approach. However, limited investigations have focused on the difference of complications in MRI-ultrasound fusion prostate biopsy (FB) between both approaches. In this study, we evaluated the safety of TP-FB and TR-FB, using a propensity score matching method. METHODS: This study was approved by the institutional ethics committee (registration number M2000-2130-01) and included consecutive 778 patients who underwent TR-FB from 2017 to 2020 (n=427) and TP-FB from 2020 to 2022 (n=351) at our hospital. For each patient, we performed 12-core systematic biopsy and 3-core targeted biopsy per a suspicious lesion using UroNav (Philips). In FB, a single dose of cefmetazole was intravenously administered as prophylactic antibiotics. Propensity score matching was used to adjust for patient characteristics including age, diabetes, use of antithrombotic drug, prostate volume, and pre-existing pyuria. Post-biopsy complications were assessed according to CTCAE v5.0. The rates of post-biopsy complications with Grade≥2 and Grade≥3 were compared between TP-FB and TR-FB, respectively. We analyzed the predictive factors for post-biopsy prostatitis with Grade≥2. RESULTS: Overall, any post-biopsy complications with Grade≥2 were observed in 11 (3.1%) TP-FB and 22 (5.2%) TR-FB patients (p=0.23), and those with Grade≥3 in 4 (1.1%) TP-FB and 12 (2.8%) TR-FB patients (p=0.13). In the adjusted cohort (325 TP-FB and 325 TR-FB), there were no differences in age, diabetes, use of antithrombotic drug, prostate volume and pre-existing pyuria. Median number of cores was 18 in both groups (p=0.65). TP-FB had significantly lower rate of Grade≥2 and Grade≥3 prostatitis than TR-FB (0.3% vs 3.4%, p<0.01 and 0% vs 2.2%, p=0.02, respectively). No significant differences were observed in any complications, urinary retention, hematuria, and rectal bleeding rates between TR-FB and TP-FB. On the multivariable analysis, TP approach was the independent predictor for lower rate of prostatitis with Grade≥2 (OR=0.09, p=0.02). CONCLUSIONS: TP-FB contributed to lower risk of post-biopsy prostatitis in comparison to TR-FB. We should offer TP approach in FB from the aspect of safety. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e783 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Hiroki Tanaka More articles by this author Masaki Kobayashi More articles by this author Kasumi Yoshitomi More articles by this author Bo Fan More articles by this author Motohiro Fujiwara More articles by this author Yuki Nakamura More articles by this author Yudai Ishikawa More articles by this author Shohei Fukuda More articles by this author Yuma Waseda More articles by this author Hajime Tanaka More articles by this author Soichiro Yoshida More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...