{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:15:43Z","timestamp":1790806543403,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:00:00Z","timestamp":1631232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare data on transperineal template biopsy (TPTB) under general anesthesia (GA) compared with local anesthesia (LA) procedures using the PrecisionPoint\u2122 Transperineal Access System (PPTAS) in relation to tolerability, cancer detection rate, complications, and cost.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective pilot cohort study of patients undergoing transperineal biopsy was performed. Patients were excluded if they had concurrent flexible cystoscopy or language barriers. Patients had a choice of GA or LA. A prospective questionnaire on Days 0, 1, 7, and 30 was applied. The primary outcome was patient tolerability. Secondary outcomes were cancer detection rate, complication rate, and theater utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 80 patients (40 GA TPTB and 40 LA PPTAS). Baseline characteristics including age, prostate\u2010specific antigen (PSA), digital rectal examination (DRE), findings, and prostate volume were comparable between the groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.3790, <jats:italic>p<\/jats:italic>\u2009=\u20090.9832, <jats:italic>p<\/jats:italic>\u2009=\u20090.444, <jats:italic>p<\/jats:italic>\u2009=\u20090.3939, respectively). Higher median prostate imaging\u2010reporting and data system (PI\u2010RADS) score of 4 (interquartile range [IQR] 2) versus 3 (IQR 1) was noted in the LA group (<jats:italic>p<\/jats:italic>\u2009=\u20090.0326). Pain was higher leaving recovery in the GA group however not significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.0555). Median pain score at LA infiltration was 5\/10 (IQR 3), with no difference in pain at Days 1, 7, or 30 (<jats:italic>p<\/jats:italic>\u2009=\u20090.2722, 0.6465, and 0.8184, respectively). For GA versus LA, the overall cancer detection rate was 55% versus 55% (<jats:italic>p<\/jats:italic>\u2009=\u20091.000) with clinically significant cancer in 22.5% versus 35% (<jats:italic>p<\/jats:italic>\u2009=\u20090.217). Acute urinary retention (AUR) occurred in 5% of GA and 2.5% of LA patients (<jats:italic>p<\/jats:italic>\u2009=\u20091.000). The GA cohort spent longer in theater and in recovery with a median of 93.5\u2009min versus 57\u2009min for the LA group (<jats:italic>p<\/jats:italic>\u2009=\u2009&lt;0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that transperineal biopsy is safely performed under LA with no difference between the cohorts in relation cancer detection or AUR. LA biopsy also consumed less theater and recovery resources. A further larger prospective randomized controlled trial is required to confirm the findings of this study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.106","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T10:48:45Z","timestamp":1631270925000},"page":"428-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Local versus general anesthesia transperineal prostate biopsy: Tolerability, cancer detection, and complications"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2563-5056","authenticated-orcid":false,"given":"Donnacha","family":"Hogan","sequence":"first","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"},{"name":"School of Medicine University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2605-0463","authenticated-orcid":false,"given":"Abbie","family":"Kanagarajah","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"},{"name":"Melbourne Medical School The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1955-6992","authenticated-orcid":false,"given":"Henry H.","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-3642","authenticated-orcid":false,"given":"David","family":"Wetherell","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"},{"name":"Department of Urology Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Dundee","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"},{"name":"Department of Urology Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-1087","authenticated-orcid":false,"given":"Homayoun","family":"Zargar","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8565-1301","authenticated-orcid":false,"given":"Helen E.","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-020-0204-8"},{"issue":"1","key":"e_1_2_8_3_1","first-page":"19","article-title":"Transrectal ultrasound\u2010guided versus transperineal mapping prostate biopsy: complication comparison","volume":"20","author":"Skouteris VM","year":"2018","journal-title":"Rev Urol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12536"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13031"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15062"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.11.015"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq471"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-017-2043-3"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13209"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2011.10759.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2018.01.021"},{"key":"e_1_2_8_13_1","unstructured":"FDA. 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