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Abstract

Medicine

Micro-Ultrasound Guided Transperineal Prostate Biopsy: A Clinic-Based Procedure

Published: February 3rd, 2023

DOI:

10.3791/64772

1Department of Urology, University of Florida College of Medicine, 2Division of Urology, North Mississippi Medical Center, 3Department of Radiology, University of Florida College of Medicine, 4Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, 5Department of Anesthesiology, University of Florida College of Medicine, 6Center for Safety, Simulation & Advanced Learning Technologies, University of Florida, 7Department of Emergency Medicine, Gulhane School of Medicine

Abstract

Prostate cancer is the most common solid malignancy in men and requires a biopsy for diagnosis. This manuscript describes a freehand micro-ultrasound guided transperineal technique performed under local anesthesia, which maintains accuracy, keeps patients comfortable, has low adverse events, and minimizes the need for disposables. Prior micro-ultrasound-guided transperineal techniques required general or spinal anesthesia. The key steps described in the protocol include (1) the placement of the local anesthesia, (2) micro-ultrasound imaging, (3) and the visualization of the anesthetic/biopsy needle while uncoupled from the insonation plane. A retrospective review of 100 patients undergoing this technique demonstrated a 68% clinically significant cancer detection rate. Pain scores were prospectively collected in a subset of patients (N = 20) and showed a median procedural pain score of 2 out of 10. The 30 day Grade III adverse event rate was 3%; one of these events was probably related to the prostate biopsy. Overall, we present a simple, accurate, and safe technique for performing a micro-ultrasound-guided transperineal prostate biopsy.

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Keywords Prostate Biopsy

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