A single center evaluation of single use, disposable transperineal prostate biopsy guide with pivot feature

Document Type

Conference Proceeding

Publication Date

3-1-2024

Publication Title

Eur Urol

Abstract

Introduction & Objectives: Transrectal biopsy is associated with a 1-2% risk of serious infection leading to hospitalization. Transperineal (TP) prostate biopsy has been gaining popularity due to a lower rate of post-procedural sepsis. There are several TP biopsy guides, which are categorized into single-use disposable and reusable. In this video, we demonstrate the safety and efficacy of our technique performing TP biopsy in both clinic and OR settings using a disposable needle guide with a pivot feature. Materials & Methods: An adjustable disposable needle guide with a pivot capability (TP Pivot Pro™ transperineal needle guide, Civco Medical Solutions) attached to a biplanar ultrasound probe was evaluated for TP biopsy. Biopsies were performed in the clinic setting with local anesthesia, and in the OR with sedation and local anesthesia. Prostate samples were obtained using an 18-gauge x 25 cm biopsy gun. After each biopsy, physicians were asked to fill out an evaluation form regarding procedural set up, post-procedural outcomes, and physician perception of device usability scored from 1 to 5 on a Likert scale (1=completely disagree, 5 = completely agree). Forms were collected to determine overall complication rates and efficacy of the biopsy guides. Results: From January to June 2023, five urologists performed a total of 61 TP biopsies using the disposable needle guide. The needle guide was used with the Mindray, ExactVu, BK Medical, and Koelis Trinity ultrasound systems. 33% of TP biopsies utilized MRI fusion technique. 53% of biopsies were only performed systematically, while the remaining also included targeted biopsies. 44% of procedures occurred in the clinic setting. Overall, physicians reported a positive user experience with the disposable needle guide. The mean survey response for each question ranged from 4.2 and 4.9 (between agree and completely agree). Physicians specifically appreciated the guide's ability to pivot the biopsy needle angle, which allowed better access to the anterior and posterior prostate. Only 2 (3.3%) patients experienced post-procedural complications. One patient experienced urinary retention due to large prostate and another patient experienced hematuria. 75% of patients did not receive prophylactic antibiotics, and there were no reported post-procedural infections. Conclusions: We demonstrated that TP prostate biopsy using a disposable needle guide can be safely used in the clinic and OR setting with minimal complications. There is a potential reduction in infections with the use of a disposable needle guide. Additionally, the pivoting function of the needle guide is a unique feature not present in other guides.

Volume

85

First Page

S651

Last Page

S651

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