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Comparative Study
. 2024 Sep 25;42(1):535.
doi: 10.1007/s00345-024-05245-1.

Transrectal versus transperineal prostate fusion biopsy: a pair-matched analysis to evaluate accuracy and complications

Marco Oderda  1 , Romain Diamand  2 , Rawad Abou Zahr  3 , Julien Anract  4 , Gregoire Assenmacher  5 , Nicolas Barry Delongchamps  4 , Alexandre Patrick Bui  6 , Daniel Benamran  7 , Giorgio Calleris  8 , Charles Dariane  9 , Mariaconsiglia Ferriero  10 , Gaelle Fiard  11 , Fayek Taha  6 , Alexandre Fourcade  12 , Georges Fournier  12 , Karsten Guenzel  13 , Adam Halinski  14 , Giancarlo Marra  8 , Guillaume Ploussard  15 , Katerina Rysankova  16 , Jean-Baptiste Roche  17 , Giuseppe Simone  10 , Olivier Windisch  7 , Paolo Gontero  8
Affiliations
Comparative Study

Transrectal versus transperineal prostate fusion biopsy: a pair-matched analysis to evaluate accuracy and complications

Marco Oderda et al. World J Urol. .

Abstract

Purpose: To evaluate biopsy-related complications and detection rates of any PCa and clinically significant PCa (csPCa, intended as grade group ≥ 2) between MRI-targeted TP fusion biopsies (TPBx) and TR ones (TRBx).

Methods: We performed a multicentric study on 4841 patients who underwent fusion biopsy between 2016 and 2023. A case-control matching was performed to find comparable cohorts of 646 TPBx and 646 TRBx. Mean T test and Pearson chi-square tests were used to compare continuous and categorical variables.

Results: Baseline characteristics were comparable between the cohorts, except for target location with a higher rate of anterior lesions in TPBx group. Complications were rare and no difference was found between the groups, with similar rates of infections after TRBx and TPBx (N = 5 (0.8%) vs N = 2 (0.3%), p 0.45). All patients in TRBx and 90.1% in TPBx group received antibiotic prophylaxis. A higher csPCa detection rate was found in TPBx over the group (50.5% vs 36.2%, p < 0.001). On average, positive targeted cores were increased in TPBx group, for any PCa (1.6 vs 1.4, p 0.04) and csPCa (1.0 vs 0.8, p 0.02). Among the limitations of study, we acknowledge the retrospective design and the possible under-reporting of complications.

Conclusions: MRI-targeted fusion TPBx achieves a significantly higher csPCa detection than TRBx, with a diagnostic advantage for apical and anterior lesions. No significant differences were found in terms of complications that were rare in both groups, considering a widespread adoption of antibiotic prophylaxis.

Keywords: Accuracy; Comparison; Complications; Fusion; Prostate biopsy; Transperineal; Transrectal.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.. Marco Oderda, Karsten Guenzel and Nicolas Barry Delongchamps have received speaker honoraria by Koelis™.

Figures

Fig. 1
Fig. 1
Study flowchart
See this image and copyright information in PMC

Comment in

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