OBJECTIVE
To evaluate the feasibility of “in-office” TPFBx under local anesthesia (LA).
MATERIALS AND METHODS
We prospectively screened for eligibility data of 724 consecutive men undergoing either
TPFBx (target and systematic cores) or TPSBx (systematic cores only) from September
2016 to June 2018 due to suspicion of prostate cancer (CaP), according to predefined
exclusion criteria.
RESULTS
We included 459 men (TPFBx n = 279 including n = 338 mpMRI lesions, Pi-RADS 4 in 63.6%; TPSBx n = 180). Median procedural time and maximum pain were 19 minutes and 5 numeric rating
scale (NRS) points; pain was highest at the time of LA. Only 1 major complication
occurred (Clavien 3a). Hematuria and hematospermia were frequent (72.6% and 54.2%).
Vaso-vagal reactions and AUR were rare (0.7% and 0.4%). No cases of UTI and 1 case
of fever were recorded. No significant changes in erectile and urinary functions were
noted from baseline compared to 40 days after TPFBx (P = .86 and P = .89). In comparison with TPSBx the sole differences were pain during prostatic
sampling (P = .03), duration of hematospermia (P <.0001) and procedural time (P <.001) all higher for TPFBx. Clinically significant (cs) CaP was detected in n = 150 (53.8%) patients in the TPFBx group (34.9%, 51.7%, and 75% of Pirads 3, 4,
and 5, respectively). Addition of systematic cores detected n = 25 csCaP that were missed by targeted cores (17.4% of all csCaP).
CONCLUSION
TPFBx under LA are feasible, yielding high tolerability, low complications, no impact
on erectile and urinary function and good csCaP detection. Addition of systematic
to targeted cores remains recommended. Further studies are needed to confirm our findings.
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Article info
Publication history
Published online: February 13, 2020
Accepted:
November 12,
2019
Received:
July 24,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.