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The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

Prostate biopsies without antibiotic cover – are we there yet?

Transperineal (TP) prostate biopsies are widely replacing the traditional transrectal route due to definite evidence of reduced infective complications. TP biopsies are usually performed with a single dose of antibiotic pre-procedure in most centres. In this article the authors attempt...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

Evaluation of the learning curve for learning MRI-US fusion prostate biopsies

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be implementing MRI-US transrectal or transperineal fusion biopsies to their clinical practice. This prospective cohort study evaluated 779 consecutive...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...

Is routine renal tumour biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?

There has been a considerable increase in the detection of small renal masses (SRM). Approximately 20% of these turn out to be benign lesions on final histopathological analysis. Therefore upfront surgery can be overtreatment in such a group of patients....

Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?

Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...

Prostate cancer mortality among elderly men after discontinuing organised screening

This study presents ground-breaking insights into discontinuing prostate cancer (PCa) screening in previously screened elderly men, aiming to mitigate the risk of overdiagnosis and overtreatment in the face of other-cause mortality. Examining men aged 70–74 who had undergone prostate specific...

Prostate Cancer Diagnosis – PSA, Biopsy and Beyond

The danger of many of the texts which deal with this rapidly changing field is that by the time the texts are published they are out of date. This book however remains fresh, in part because it acknowledges that there...

Improving on the Rotterdam Prostate Cancer Risk Calculator

Following the PROMIS trial [1], many cancer centres in the UK are now offering pre-biopsy multiparametric MRI (mpMRI) for men suitable for radical treatment. The European Association of Urology for Prostate Cancer (PCa) guidelines recommend individual risk stratification before the...

ASAP: is a repeat biopsy necessary?

This study examined the validity of current US and European guidelines on the management of patients diagnosed with atypical small acinar proliferation (ASAP). Current guidance states that these patients should undergo repeat biopsy within three to six months due to...

A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...