Transperineal Ultrasound Guided Template Saturation Prostate Biopsy: Report of 2066 Cases

  Objective  To assess the efficacy and safety of transperineal ultrasound guided template saturation prostate biopsy.

  Methods  In a prospective study, a total of 2066 patients (26-92 years old, mean:70.2 years) who met the inclusion criteria underwent transperineal ultrasound guided saturation prostate biopsy using an 11-region template. The inclusion criteria included:a prostate specific antigen (PSA) level of 4.0 ng/ml or greater and abnormal prostate gland findings on digital rectal examination, ultrasound, CT, and/or MRI. Of these 2066 patients, the median PSA level was 11.7 ng/ml (range:0.2-5000 ng/ml) and the median prostate volume was 45.0 ml (range:7-450 ml).

  Results  Prostate cancer was detected in 812 of 2066 patients (39.3%). The prostate cancer detection rates in groups with PSA 0-4.0, 4.1-10.0, 10.1-20.0, 20.1-50.0, 50.1-100.0, and > 100.1 ng/ml groups were 24.1% (28/116), 18.9% (140/739), 30.4% (192/631), 56.3% (148/263), 84.5% (130/142), and 99.4% (174/175), respectively. Among all these 2066 patients, 785 (38.0%) had mild and transient (1 to 7 days) hematuria, 42 (2.1%) had urinary retention, and 1 (0.05%) had septic shock postoperatively. No patient died during the procedure.

  Conclusion  Transperineal ultrasound guided template saturation prostate biopsy is a safe and accurate procedure and can be useful for the precise TNM staging and the treatment decision-making.