A comparison of complications following transperineal and transrectal prostate biopsy in Rajavithi Hospital
DOI:
https://doi.org/10.52786/isu.a.114Keywords:
Transrectal, transperineal, biopsy, complications, MRI fusion biopsyAbstract
Objective: Prostate cancer is one of the most prevalent cancers globally. While transrectal ultrasound-guided biopsy remains the gold standard, it carries several risks of complication. Recent advancements in 3D magnetic resonance imaging have improved cancer detection rates and reduced the incidence and severity of complications. Since 2021, Rajavithi Hospital has implemented this technology, yielding promising results but lacking comprehensive data regarding complications. The objective of this study is to compare the complications associated with prostate biopsy via the perineum versus the rectum and investigate the factors related to the occurrence of complications from prostate biopsy.
Materials and Methods: This retrospective study was performed using data from patients who underwent MRI fusion prostate biopsy in the Division of Urology, Department of Surgery, Rajavithi Hospital between 2021 and 2024. Data were collected from medical records, including age, digital rectal examination, PIRADS score, history of previous biopsy, biopsy core, Gleason score, prostate volume, PSA, and methods.
Results: A total of 200 patients underwent prostate biopsy, with 150 patients (75.0%) receiving the procedure via the transperineal route and 50 patients (25.0%) via the transrectal route. A total of 34 patients experienced complications: 26 in the the transperineal approach group and 8 in the transrectal approach group. A urinary tract infection (UTI) was reported in several cases after the transrectal procedure, but the findings were not statistically significant (p = 0.250). Complications such as gross hematuria, LUTS, pain, hematochezia, hematospermia, and AUR occurred variably without statistical significance.
Conclusion: This study found no significant difference in complications associated with prostate biopsy via the perineum and the rectum. The most common complication from both methods is lower urinary tract symptoms (LUTS).
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