Our Summary

This study looks at two methods of diagnosing prostate cancer: transperineal prostate biopsy (TPB) and transrectal prostate biopsy (TRB). It was conducted in a major hospital in Taiwan from January to October 2021. TPB is a newer method and can be more expensive due to the extra equipment required, which has limited its use.

In this study, the researchers used the same setup for both biopsy methods, using a specific type of ultrasound. They compared the complications and success rate of detecting cancer between the two groups.

They found that the two methods had similar success rates in detecting cancer. However, the group that received TPB had significantly fewer complications overall, and importantly, no cases of infection. There were five recorded infections in the group that received TRB.

The study concludes that TPB is a safe, practical, and cost-effective alternative to TRB. It can prevent hospitalizations due to infection and doesn’t require much additional resources. Therefore, it could be a beneficial method for diagnosing prostate cancer.

FAQs

  1. What are the two methods of diagnosing prostate cancer discussed in the study?
  2. Did the study find any significant difference in the success rates of TPB and TRB in detecting prostate cancer?
  3. What are the advantages of using TPB over TRB according to the study?

Doctor’s Tip

A doctor might tell a patient about prostate biopsy:

  • It is important to follow all pre-biopsy instructions provided by your healthcare provider, such as avoiding certain medications or foods.
  • Make sure to inform your doctor about any allergies or medical conditions you have before the procedure.
  • It is normal to experience some discomfort or mild bleeding after the biopsy, but contact your doctor if you have severe pain, fever, or heavy bleeding.
  • Follow-up appointments are crucial to discuss the results of the biopsy and determine the next steps in your treatment plan.
  • Remember that early detection of prostate cancer can lead to more effective treatment options, so it is important to undergo recommended screenings and biopsies as advised by your doctor.

Suitable For

Patients who are typically recommended for a prostate biopsy are those who have abnormal results from a prostate-specific antigen (PSA) test, digital rectal exam (DRE), or imaging studies such as a transrectal ultrasound (TRUS). Additionally, patients with a family history of prostate cancer or those with symptoms such as frequent urination, blood in the urine, or difficulty urinating may also be recommended for a biopsy. Ultimately, the decision to undergo a prostate biopsy is made by a healthcare provider after considering the patient’s individual risk factors and symptoms.

Timeline

Before the prostate biopsy:

  1. Patient consults with a doctor and discusses the need for a biopsy based on symptoms and test results.
  2. Patient may undergo a digital rectal exam (DRE) to assess the prostate gland.
  3. Patient may undergo a prostate-specific antigen (PSA) blood test to measure levels of a protein produced by the prostate.
  4. Patient may receive instructions on how to prepare for the biopsy, such as avoiding blood-thinning medications.

During the prostate biopsy:

  1. Patient is positioned on their side or back with their knees bent.
  2. Local anesthesia is administered to numb the area.
  3. A thin needle is inserted into the prostate gland to collect tissue samples.
  4. Multiple samples may be taken from different areas of the prostate.
  5. The procedure typically takes about 10-15 minutes.

After the prostate biopsy:

  1. Patient may experience some discomfort or minor bleeding at the biopsy site.
  2. Patient may be advised to avoid heavy lifting or strenuous activities for a few days.
  3. Pathology results from the biopsy are typically available within a week.
  4. Patient meets with the doctor to discuss the biopsy results and determine next steps for treatment, if necessary.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a prostate biopsy?
  2. How is a transperineal prostate biopsy different from a transrectal prostate biopsy?
  3. What is the success rate of detecting prostate cancer with each biopsy method?
  4. Are there any specific criteria that make a patient a better candidate for one biopsy method over the other?
  5. What is the cost difference between a transperineal prostate biopsy and a transrectal prostate biopsy?
  6. How long does it take to recover from a prostate biopsy?
  7. What follow-up care is recommended after a prostate biopsy?
  8. Are there any lifestyle changes or precautions that should be taken after a prostate biopsy?
  9. How often should a patient undergo a prostate biopsy if they have a history of prostate cancer in their family?
  10. Are there any alternative diagnostic tests or procedures that can be considered instead of a prostate biopsy?

Reference

Authors: Wu RC, Tung MC, Wu CH, Mai HC, Huang WL, Chen SH, Lin VC. Journal: Int Urol Nephrol. 2023 Nov;55(11):2695-2701. doi: 10.1007/s11255-023-03705-y. Epub 2023 Jul 28. PMID: 37505427