gms | German Medical Science

68. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie

Nordrhein-Westfälische Gesellschaft für Urologie e. V.

30.03. - 31.03.2023, Essen

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Comparison of complications after transperineal and transrectal prostate biopsy in a risk stratified pathway. Inverse probability of treatment weighting analysis after clinical implementation of the updated European Association of Urology guideline recommendations on prostate biopsy

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  • presenting/speaker Sebastian Berg - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Karl Tully - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Vincent Hoffmann - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Nicolas von Landenberg - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Henning Bahlburg - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Florian Roghmann - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Guido Mueller - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany; Zentrum für Urologische Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
  • Joachim Noldus - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany
  • Moritz Reike - Marien Hospital Herne, Universitätsklinikum Ruhr, Universität Bochum, Herne, Germany

Nordrhein-Westfälische Gesellschaft für Urologie. 68. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie. Essen, 30.-31.03.2023. Düsseldorf: German Medical Science GMS Publishing House; 2023. DocV 1.2

doi: 10.3205/23nrwgu02, urn:nbn:de:0183-23nrwgu023

Published: March 28, 2023

© 2023 Berg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Evidence for superiority of transperineal (TP) over transrectal (TR) biopsy is growing due to lower infectious complications rates. However, TR biopsy is the most common procedure and it seems that a cross over to TP is delayed by logistical challenges such as costs, complexity and lack of experience. We investigate if well selected patients without any risk factors may be further undergo TR biopsy when all precautions to avoid infections are warranted.

Methods: Data were collected in our academic institution between 08/2021 and 03/2022 and after clinical implementation of the currently updated European Association of Urology guideline recommendations on performance of prostate biopsy. Patients underwent either TP or TR biopsy according to a risk stratification based on risk factors of infectious complications. Follow-up asked for post-biopsy complications. Inverse Probability of Treatment Weighting (IPTW) propensity score was used to balance baseline characteristics. Complications were subdivided into infectious and non-infectious complications.

Results: In total, 294 patients were included. 161 patients underwent TR vs. 133 patients who underwent TP biopsy. Complication rates were 2.2% for TP vs. 5.5% for TR biopsy concerning all complications. Infectious complication rates only were 0.7% for TP vs. 1.8% for TR biopsy. After IPTW-adjustment, differences were statistically significant different.

Conclusion: Our study revealed that even in a well selected patient cohort with presumably healthy men TR biopsy leads to more post-biopsy complications than the TP biopsy. This conclusion should motivate the urological community to cross over to TP biopsy.