Re: Transperineal Template-Guided Prostate Biopsy: 10 Years Of Experience

• To assess the efficacy and safety of transperineal template-guided prostate biopsy.• From December 2003 to December 2013, a total of 3007 patients (30-91 years old, mean age 69.1) who met the inclusion criteria underwent 11-region transrectal ultrasound-guided transperineal template prostate biopsy. • 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 or MRI. The median PSA level was 11.0 ng/ml (range 0.2-100 ng/ml). • The prostate cancer detection rate and prostate biopsy adverse effects, as well as prostate cancer spatial distribution were analyzed.• A mean of 19.3 cores (range 11 to 44) were obtained for each biopsy, and more cores were obtained in larger prostates than in smaller ones. • One to four cores were collected from each region. Prostate cancer was detected in 1067 of the 3007 patients (35.5%). The prostate cancer detection rates in groups with PSA levels of 0-4.0 ng/ml, 4.1-10.0 ng/ml, 10.1-20.0 ng/ml, 20.1-50.0 ng/ml, and 50.1-100.0 ng/ml were 15.3% (27/176), 21.0% (248/1179), 32.6% (318/975), 56.0% (232/414), and 92.0% (241/262), respectively. • The mean positives for cancer in regions 1-10 and region 11 (the apical region) were 46.7% vs. 52.0% (P=0.014). • Regarding adverse effects, 47.0% of the patients reported hematuria, 6.1% developed hemospermia, 1.9% required short-term catheterization after biopsy because of acute urinary retention, and 0.03% (one patient) developed urosepsis.• Transrectal ultrasound-guided transperineal template prostate biopsy is safe and accurate. • The current study suggests that prostate carcinoma foci are more frequently localized in the apical region.