Contribution of the transperineal prostatic biopsy: descriptive study of the first cases at the Hôpital Général Idrissa Pouye, Dakar

Abstract

Introduction: Prostate cancer is one of the most common malignancies among men aged over 50 years and the  leading cause of cancer-related death in men after lung cancer. Diagnosis is done by transrectal or transperineal prostate biopsy with ultrasound guidance. While transrectal biopsy exposes the patient to infectious risk, a transperineal biopsy is an innovative technique with the advantage of limiting these risks and offering better anterior prostate sampling. It is replacing transrectal biopsy, known as the gold standard for prostate cancer diagnosis. Our study aims to describe the practice of transperineal prostate biopsy at Hôpital Général Idrissa Pouye (HOGIP), evaluate morbidity, and present the results.

Materials and methods: We conducted a descriptive, single-centre and cross-sectional study of patients who underwent a transperineal prostate biopsy at the urology department of HOGIP. We collected epidemiological, clinical, and paraclinical data. Analysis was done in Epi Info 7.2.5.0, and statistical significance was considered for α = 0.05 and, therefore, a p-value < 0.05.

Results: The average age was 69 ± 7.60 years. Digital rectal examination was suspicious in 27 (66%) patients, and the median prostate-specific antigen (PSA) level was 24.525 ng/ml (interquartile range [IQR]: 18.39–67.43). The average visual analogue scale (VAS) for the pain rate was 3.6. Prostatic adenocarcinoma was diagnosed in 31 (76%) patients. Haematuria was the most frequent post-procedural complication observed in six (14.6%) patients. Two prostatitis cases were noted, and no cases of sepsis were reported.

Conclusion: Transperineal prostate biopsy contributes to reducing the number of post-procedural complications and provides better sampling of the anterior prostate than transrectal biopsy.