Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 28;3(6):434-442.
doi: 10.1002/bco2.178. eCollection 2022 Nov.

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

Michael Tzeng  1 , Spyridon P Basourakos  1 , Hiten D Patel  2 , Matthew J Allaway  3 , Jim C Hu  1 , Michael A Gorin  3   4
Affiliations
Review

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

Michael Tzeng et al. BJUI Compass. .

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.

Keywords: PrecisionPoint; biopsy; diagnostic techniques; prostatic neoplasms; sepsis; surgical; transperineal.

PubMed Disclaimer

Conflict of interest statement

MJA is the inventor of the PrecisionPoint device and co‐owner of Perineologic. MAG is a paid consultant to BK Medical ApS, Perineologic, and KOELIS, Inc. The remaining authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Images of the PrecisionPoint Transperineal Access System (Perineologic, Cumberland, MD). (A) The assembled PrecisionPoint device is composed of an access trocar, needle guide, and rail/clamp subassembly. (B) The PrecisionPoint device attached to a model 8658 biplanar transrectal ultrasound probe (BK Medical, Peabody, MA)
FIGURE 2
FIGURE 2
Forest plots for cancer detection rates of (A) overall and (B) clinically significant prostate cancer
See this image and copyright information in PMC

References

    1. Bennett HY, Roberts MJ, Doi SAR, Gardiner RA. The global burden of major infectious complications following prostate biopsy. Epidemiol Infect. 2016;144(8):1784–91. 10.1017/S0950268815002885 - DOI - PMC - PubMed
    1. Pradere B, Veeratterapillay R, Dimitropoulos K, Yuan Y, Omar MI, MacLennan S, et al. Nonantibiotic strategies for the prevention of infectious complications following prostate biopsy: A systematic review and meta‐analysis. J Urol. 2021;205(3):653–63. 10.1097/JU.0000000000001399 - DOI - PubMed
    1. Pepe P, Garufi A, Priolo G, Pennisi M. Transperineal versus transrectal MRI/TRUS fusion targeted biopsy: Detection rate of clinically significant prostate cancer. Clin Genitourin Cancer. 2017;15(1):e33–6. 10.1016/j.clgc.2016.07.007 - DOI - PubMed
    1. Ber Y, Segal N, Tamir S, Benjaminov O, Yakimov M, Sela S, et al. A noninferiority within‐person study comparing the accuracy of transperineal to transrectal MRI‐US fusion biopsy for prostate‐cancer detection. Prostate Cancer Prostatic Dis. 2020;23(3):449–56. 10.1038/s41391-020-0205-7 - DOI - PMC - PubMed
    1. Meyer AR, Mamawala M, Winoker JS, Landis P, Epstein JI, Macura KJ, et al. Transperineal prostate biopsy improves the detection of clinically significant prostate cancer among men on active surveillance. J Urol. 2021;205(4):1069–74. 10.1097/JU.0000000000001523 - DOI - PubMed

LinkOut - more resources