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Objective: Freehand transperineal prostate biopsy (fTP-Bx) has been established as an alternative within the transperineal approach for prostate cancer (CaP) diagnosis. The primary objective was to compare the rate of overall CaP detection and clinically significant (greater than or equal to International Society of Urological Pathology 2) in patients with biopsy-naive between freehand transperineal prostate biopsy (fTP-Bx) and transperineal grid biopsy (TP-Bx) techniques. The secondary objective was to show the characteristics of the procedure and measure the associated complications.
Methods: A retrospective review of all patients who underwent fTP-Bx (n: 326) and TP-Bx (n: 118) in our department was conducted between October 2020 and May 2023 due to suspected CaP based on elevated prostate-specific antigen (PSA), suspicious digital rectal examination, or those under active surveillance protocol. The chisquare test and Fisher's exact test were used to compare categorical variables.
Results: A retrospective review of all patients who underwent fTP-Bx (n: 326) and TP-Bx (n: 118) in our department was conducted between October 2020 and May 2023 due to suspected CaP based on elevated prostate-specific antigen (PSA), suspicious digital rectal examination, or those under active surveillance protocol. The chisquare test and Fisher's exact test were used to compare categorical variables.
Conclusion: Freehand transperineal prostate biopsy achieved a higher rate of clinically significant CaP detection than TP-Bx in biopsy-naive patients, accompanied by a lower number of postoperative complications.
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http://dx.doi.org/10.5152/tud.2025.24026 | DOI Listing |
Diagnostics (Basel)
July 2025
Emergency Clinical County Hospital Brasov, 500365 Brașov, Romania.
To diagnose prostate cancer, a prostate biopsy is required. Two methods are commonly used for biopsy: transrectal and transperineal. The transperineal approach, particularly the "freehand" technique under local anesthesia, offers better access to the anterior prostate, lower infection risk, and higher detection rates.
View Article and Find Full Text PDFIndian J Urol
July 2025
Department of Urology, Ashford and St Peter's Hospitals, NHS Foundation Trust, Chertsey, Surrey, United Kingdom.
Introduction: Transperineal access systems are commonly used to stabilize the biopsy needle with the ultrasound probe in local anesthetic transperineal biopsies (LATPs). However, these devices are expensive and nonreusable and restrict the access to some of the prostatic zones causing excessive probe movement and procedural pain. We aim to assess the pain tolerability, diagnostic value, and safety of the totally freehand LATP (tF-LATP) technique.
View Article and Find Full Text PDFComput Biol Med
September 2025
Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, INSERM, TIMC, 38000 Grenoble, France.
Background: Diagnosis of prostate cancer requires histopathology of tissue samples. Following an MRI to identify suspicious areas, a biopsy is performed under ultrasound (US) guidance. In existing assistance systems, 3D US information is generally available (taken before the biopsy session and/or in between samplings).
View Article and Find Full Text PDFCancers (Basel)
July 2025
Division of Urology, Department of Surgical Sciences, Molinette Hospital, University of Turin, 10126 Torino, Italy.
: prostate fusion biopsies are key in the diagnosis of prostate cancer (PCa); however, the fusion imaging system is not always user-friendly or reliable. The aim of this study was to assess the feasibility, accuracy, and effectiveness of transperineal fusion biopsies performed with a novel fusion imaging device equipped with AI-driven auto-contouring. : data from 148 patients who underwent MRI-targeted and systematic prostate fusion biopsy with UroFusion (Esaote) were prospectively collected.
View Article and Find Full Text PDFCancers (Basel)
June 2025
Department Surgery, Oncology and Gastroenterology, Urology Clinic, University of Padua, 35126 Padua, Italy.
: It remains unclear whether certain areas of the prostate are more difficult to accurately sample using MRI/US-fusion-guided freehand single-access transperineal prostate biopsy (FSA-TP). The aim of this study was to evaluate the detection rates of clinically significant (cs) and clinically insignificant (ci) prostate cancer (PCa) in each prostate zone during FSA-TP MRI-target biopsies (MRI-TBs) and systematic biopsies (SB). : This monocentric observational study included a cohort of 277 patients with no prior history of PCa who underwent 3 MRI-TB cores and 14 SB cores with an FSA-TP from January to December 2023.
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