Indications, results and safety profile of transperineal sector biopsies ( TPSB ) of the prostate: a single centre experience of 634 cases

Objective To describe a protocol for transperineal sector biopsies ( TPSB ) of the prostate and present the clinical experience of this technique in a UK population.Patients and Methods A retrospective review of a single‐centre experience of TPSB approach was undertaken that preferentially, but not exclusively, targeted the peripheral zone of the prostate with 24–38 cores using a ‘sector plan’. Procedures were carried out under general anaesthetic in most patients. Between J anuary 2007 and A ugust 2011, 634 consecutive patients underwent TPSB for the following indications: prior negative transrectal biopsy ( TRB ; 174 men); primary biopsy in men at risk of sepsis (153); further evaluation after low‐risk disease diagnosed based on a 12‐core TRB (307).Results Prostate cancer was found in 36% of men after a negative TRB ; 17% of these had disease solely in anterior sectors. A s a primary diagnostic strategy, prostate cancer was diagnosed in 54% of men (median PSA level was 7.4 ng/mL). Of men with G leason 3+3 disease on TRB , 29% were upgraded and went on to have radical treatment. Postoperative urinary retention occurred in 11 (1.7%) men, two secondary to clots. Per‐urethral bleeding requiring hospital stay occurred in two men. There were no cases of urosepsis.ConclusionsTPSB of the prostate has a role in defining disease previously missed or under‐diagnosed by TRB . The procedure has low morbidity.