{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T11:23:58Z","timestamp":1777289038243,"version":"3.51.4"},"reference-count":83,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA241758"],"award-info":[{"award-number":["CA241758"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["CER-2019C2-17372"],"award-info":[{"award-number":["CER-2019C2-17372"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,28]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Approximately one million prostate biopsies are performed annually in the USA, and most are performed using a transrectal approach under local anaesthesia. The risk of postbiopsy infection is increasing due to increasing antibiotic resistance of rectal flora. Single-centre studies suggest that a clean, percutaneous transperineal approach to prostate biopsy may have a lower risk of infection. To date, there is no high-level evidence comparing transperineal versus transrectal prostate biopsy. We hypothesise that transperineal versus transrectal prostate biopsy under local anaesthesia has a significantly lower risk of infection, similar pain\/discomfort levels and comparable detection of non-low-grade prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will perform a multicentre, prospective randomised clinical trial to compare transperineal versus transrectal prostate biopsy for elevated prostate-specific antigen in the first biopsy, prior negative biopsy and active surveillance biopsy setting. Prostate MRI will be performed prior to biopsy, and targeted biopsy will be conducted for suspicious MRI lesions in addition to systematic biopsy (12 cores). Approximately 1700 men will be recruited and randomised in a 1:1 ratio to transperineal versus transrectal biopsy. A streamlined design to collect data and to determine trial eligibility along with the two-stage consent process will be used to facilitate subject recruitment and retention. The primary outcome is postbiopsy infection, and secondary outcomes include other adverse events (bleeding, urinary retention), pain\/discomfort\/anxiety and critically, detection of non-low-grade (grade group \u22652) prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The Institutional Review Board of the Biomedical Research Alliance of New York approved the research protocol (protocol number #18-02-365, approved 20 April 2020). The results of the trial will be presented at scientific conferences and published in peer-reviewed medical journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04815876\">NCT04815876<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-071191","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T08:10:57Z","timestamp":1684483857000},"page":"e071191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Protocol of a multicentre randomised controlled trial assessing transperineal prostate biopsy to reduce infectiouscomplications"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct04815876","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jim","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Urology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1935-483X","authenticated-orcid":false,"given":"Alec","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Urology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Vickers","sequence":"additional","affiliation":[{"name":"Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad Ezzeddine","family":"Allaf","sequence":"additional","affiliation":[{"name":"Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behfar","family":"Ehdaie","sequence":"additional","affiliation":[{"name":"Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Pavlovich","sequence":"additional","affiliation":[{"name":"Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley E","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Urology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge","family":"Ginzburg","sequence":"additional","affiliation":[{"name":"Einstein Urology, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvin","family":"George","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John N","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Urology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin T","family":"Ristau","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, University of Connecticut School of Medicine, Farmington, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Correa","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Division of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan E","family":"Shoag","sequence":"additional","affiliation":[{"name":"Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith J","family":"Kowalczyk","sequence":"additional","affiliation":[{"name":"Department of Urology, MedStar Georgetown University Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tenny R","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"EM","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"2025121509365004000_13.5.e071191.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.06.057"},{"key":"2025121509365004000_13.5.e071191.2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djm119"},{"key":"2025121509365004000_13.5.e071191.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6036"},{"key":"2025121509365004000_13.5.e071191.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7248"},{"key":"2025121509365004000_13.5.e071191.5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit193"},{"key":"2025121509365004000_13.5.e071191.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67453-8"},{"key":"2025121509365004000_13.5.e071191.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.08.004"},{"key":"2025121509365004000_13.5.e071191.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.3710"},{"key":"2025121509365004000_13.5.e071191.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2011.04.064"},{"key":"2025121509365004000_13.5.e071191.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.11.015"},{"key":"2025121509365004000_13.5.e071191.11","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1016\/j.juro.2013.12.026","article-title":"Infection related hospitalizations after prostate biopsy in a statewide quality improvement collaborative","volume":"191","author":"Womble","year":"2014","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2011.07.1392"},{"key":"2025121509365004000_13.5.e071191.13","first-page":"5135","article-title":"Multi-drug resistant E.coli urosepsis in physicians following transrectal ultrasound guided prostate biopsies--three cases including one death","volume":"17","author":"Carlson","year":"2010","journal-title":"Can J Urol"},{"key":"2025121509365004000_13.5.e071191.14","doi-asserted-by":"crossref","DOI":"10.5489\/cuaj.785","article-title":"Catastrophic sepsis and hemorrhage following transrectal ultrasound guided prostate biopsies","volume":"4","author":"Toren","year":"2010","journal-title":"Can Urol Assoc J"},{"key":"2025121509365004000_13.5.e071191.15","doi-asserted-by":"crossref","DOI":"10.1097\/01.ju.0000099351.37696.3a","article-title":"Disseminated intravascular coagulation following transrectal ultrasound guided prostate biopsy","volume":"171","author":"Al-Otaibi","year":"2004","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(99)90083-X"},{"key":"2025121509365004000_13.5.e071191.17","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/pcan.2008.11","article-title":"Acute bacterial meningitis after transrectal needle biopsy of the prostate: a case report","volume":"11","author":"Erdogan","year":"2008","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"2025121509365004000_13.5.e071191.18","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.140703"},{"key":"2025121509365004000_13.5.e071191.19","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.juro.2018.03.078","article-title":"Targeted antimicrobial prophylaxis does not always prevent sepsis after transrectal prostate biopsy","volume":"200","author":"Jiang","year":"2018","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.20","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.juro.2017.01.103","article-title":"An update of the American urological association white paper on the prevention and treatment of the more common complications related to prostate biopsy","volume":"198","author":"Liss","year":"2017","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.21","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.euf.2018.06.016","article-title":"Effect of augmented antimicrobial prophylaxis and rectal swab culture-guided targeted prophylaxis on the risk of sepsis following transrectal prostate biopsy","volume":"6","author":"Hadjipavlou","year":"2020","journal-title":"Eur Urol Focus"},{"key":"2025121509365004000_13.5.e071191.22","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13402"},{"key":"2025121509365004000_13.5.e071191.23","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/JU.0000000000000814","article-title":"Antibiotic prophylaxis for the prevention of infectious complications following prostate biopsy: a systematic review and meta-analysis","volume":"204","author":"Pilatz","year":"2020","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.24","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1038\/s41391-021-00438-w","article-title":"Exit from transrectal prostate biopsies (TREXIT): sepsis rates of transrectal biopsy with rectal swab culture guided antimicrobials versus freehand transperineal biopsy","volume":"25","author":"Newman","year":"2022","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"2025121509365004000_13.5.e071191.25","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/JU.0000000000002497","article-title":"The effect of different types of prostate biopsy techniques on post-biopsy infectious complications","volume":"208","author":"Tops","year":"2022","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.26","doi-asserted-by":"crossref","DOI":"10.1186\/s12957-019-1573-0","article-title":"Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer: a systematic review and meta-analysis","volume":"17","author":"Xiang","year":"2019","journal-title":"World J Surg Oncol"},{"key":"2025121509365004000_13.5.e071191.27","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.euros.2022.01.001","article-title":"Role of prophylactic antibiotics in transperineal prostate biopsy: a systematic review and meta-analysis","volume":"37","author":"Basourakos","year":"2022","journal-title":"Eur Urol Open Sci"},{"key":"2025121509365004000_13.5.e071191.28","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1016\/S1473-3099(22)00373-5","article-title":"Antibiotic prophylaxis versus no antibiotic prophylaxis in transperineal prostate biopsies (NORAPP): a randomised, open-label, non-inferiority trial","volume":"22","author":"Jacewicz","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2025121509365004000_13.5.e071191.29","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/JU.0000000000002251","article-title":"Infection rate after transperineal prostate biopsy with and without prophylactic antibiotics: results from a systematic review and meta-analysis of comparative studies","volume":"207","author":"Castellani","year":"2022","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2010.07.018"},{"key":"2025121509365004000_13.5.e071191.31","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.eururo.2020.10.019","article-title":"European association of urology position paper on the prevention of infectious complications following prostate biopsy","volume":"79","author":"Pilatz","year":"2021","journal-title":"Eur Urol"},{"key":"2025121509365004000_13.5.e071191.32","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1097\/JU.0000000000001523","article-title":"Transperineal prostate biopsy improves the detection of clinically significant prostate cancer among men on active surveillance","volume":"205","author":"Meyer","year":"2021","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.33","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1038\/nrurol.2013.195","article-title":"Transperineal biopsy of the prostate -- is this the future?","volume":"10","author":"Chang","year":"2013","journal-title":"Nat Rev Urol"},{"key":"2025121509365004000_13.5.e071191.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.10.009"},{"key":"2025121509365004000_13.5.e071191.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.07.098"},{"key":"2025121509365004000_13.5.e071191.36","doi-asserted-by":"crossref","DOI":"10.1186\/s12894-016-0185-z","article-title":"Comparison of the complications of traditional 12 cores transrectal prostate biopsy with image fusion guided transperineal prostate biopsy","volume":"16","author":"Huang","year":"2016","journal-title":"BMC Urol"},{"key":"2025121509365004000_13.5.e071191.37","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/bju.13711","article-title":"Multicentre evaluation of targeted and systematic biopsies using magnetic resonance and ultrasound image-fusion guided transperineal prostate biopsy in patients with a previous negative biopsy","volume":"120","author":"Hansen","year":"2017","journal-title":"BJU Int"},{"key":"2025121509365004000_13.5.e071191.38","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.17942"},{"key":"2025121509365004000_13.5.e071191.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.03.002"},{"key":"2025121509365004000_13.5.e071191.40","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/j.juro.2014.05.090","article-title":"Prospective evaluation of magnetic resonance imaging guided in-bore prostate biopsy versus systematic transrectal ultrasound guided prostate biopsy in biopsy na\u00efve men with elevated prostate specific antigen","volume":"192","author":"Quentin","year":"2014","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.06.008"},{"key":"2025121509365004000_13.5.e071191.42","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.urolonc.2013.08.006","article-title":"Target detection: magnetic resonance imaging-ultrasound fusion\u2013guided prostate biopsy","volume":"32","author":"Sonn","year":"2014","journal-title":"Urologic Oncology: Seminars and Original Investigations"},{"key":"2025121509365004000_13.5.e071191.43","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1002\/cncr.29874","article-title":"Prostate cancer detection with magnetic resonance-ultrasound fusion biopsy: the role of systematic and targeted biopsies","volume":"122","author":"Filson","year":"2016","journal-title":"Cancer"},{"key":"2025121509365004000_13.5.e071191.44","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.urolonc.2018.11.004","article-title":"Impact of prebiopsy magnetic resonance imaging of the prostate on cancer detection and treatment patterns","volume":"37","author":"Liu","year":"2019","journal-title":"Urol Oncol"},{"key":"2025121509365004000_13.5.e071191.45","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.juro.2018.01.071","article-title":"Evolving use of prebiopsy prostate magnetic resonance imaging in the Medicare population","volume":"200","author":"Rosenkrantz","year":"2018","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.46","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1056\/NEJMoa1801993","article-title":"MRI-targeted or standard biopsy for prostate-cancer diagnosis","volume":"378","author":"Kasivisvanathan","year":"2018","journal-title":"N Engl J Med"},{"key":"2025121509365004000_13.5.e071191.47","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.eururo.2021.06.026","article-title":"Effects of magnetic resonance imaging targeting on overdiagnosis and overtreatment of prostate cancer","volume":"80","author":"Vickers","year":"2021","journal-title":"Eur Urol"},{"key":"2025121509365004000_13.5.e071191.48","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1097\/JU.0000000000000617","article-title":"Update of the standard operating procedure on the use of multiparametric magnetic resonance imaging for the diagnosis, staging and management of prostate cancer","volume":"203","author":"Bjurlin","year":"2020","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.49","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.09.042"},{"key":"2025121509365004000_13.5.e071191.50","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.euo.2020.12.012","article-title":"Magnetic resonance imaging\/ultrasound fusion-guided transperineal versus magnetic resonance imaging\/ultrasound fusion-guided transrectal prostate biopsy-a systematic review","volume":"4","author":"Rai","year":"2021","journal-title":"Eur Urol Oncol"},{"key":"2025121509365004000_13.5.e071191.51","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/j.juro.2016.11.081","article-title":"Indications, utilization and complications following prostate biopsy: new York state analysis","volume":"197","author":"Halpern","year":"2017","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.52","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/bju.15062","article-title":"The clinical and financial implications of a decade of prostate biopsies in the NHS: analysis of hospital episode statistics data 2008-2019","volume":"126","author":"Tamhankar","year":"2020","journal-title":"BJU Int"},{"key":"2025121509365004000_13.5.e071191.53","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/j.1442-2042.2009.02269.x","article-title":"Simple and effective local anesthesia for transperineal extended prostate biopsy: application to three-dimensional 26-core biopsy","volume":"16","author":"Kubo","year":"2009","journal-title":"Int J Urol"},{"key":"2025121509365004000_13.5.e071191.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2018.01.021"},{"key":"2025121509365004000_13.5.e071191.55","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1097\/JU.0000000000001234","article-title":"Pain in men undergoing transperineal free-hand multiparametric magnetic resonance imaging fusion targeted biopsies under local anesthesia: outcomes and predictors from a multicenter study of 1,008 patients","volume":"204","author":"Marra","year":"2020","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.56","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7351.1448"},{"key":"2025121509365004000_13.5.e071191.57","doi-asserted-by":"crossref","unstructured":"Djurisic S , Rath A , Gaber S , et al . Barriers to the conduct of randomised clinical trials within all disease areas. Trials 2017;18.","DOI":"10.1186\/s13063-017-2099-9"},{"key":"2025121509365004000_13.5.e071191.58","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(05)80359-9"},{"key":"2025121509365004000_13.5.e071191.59","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/1740774520988500","article-title":"Patient accrual and understanding of informed consent in a two-stage consent design","volume":"18","author":"Vickers","year":"2021","journal-title":"Clin Trials"},{"key":"2025121509365004000_13.5.e071191.60","doi-asserted-by":"publisher","DOI":"10.1177\/1740774518755052"},{"key":"2025121509365004000_13.5.e071191.61","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d7894","article-title":"Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: prospective evaluation within protect study","volume":"344","author":"Rosario","year":"2012","journal-title":"BMJ"},{"key":"2025121509365004000_13.5.e071191.62","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.juro.2014.04.098","article-title":"Nationwide population based study of infections after transrectal ultrasound guided prostate biopsy","volume":"192","author":"Lundstr\u00f6m","year":"2014","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.63","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.juro.2014.07.086","article-title":"Prosbiotate: a multicenter, prospective analysis of infectious complications after prostate biopsy","volume":"193","author":"Bruy\u00e8re","year":"2015","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.64","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.06.003"},{"key":"2025121509365004000_13.5.e071191.65","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.12.058"},{"key":"2025121509365004000_13.5.e071191.66","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.urology.2014.12.062","article-title":"For single dosing, levofloxacin is superior to ciprofloxacin when combined with an aminoglycoside in preventing severe infections after prostate biopsy","volume":"85","author":"Unnikrishnan","year":"2015","journal-title":"Urology"},{"key":"2025121509365004000_13.5.e071191.67","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.09.121"},{"key":"2025121509365004000_13.5.e071191.68","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1089\/sur.2013.138","article-title":"Control of infective complications of transrectal prostate biopsy","volume":"15","author":"Park","year":"2014","journal-title":"Surg Infect (Larchmt)"},{"key":"2025121509365004000_13.5.e071191.69","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017863","article-title":"A multicentre randomised controlled trial assessing whether MRI-targeted biopsy is non-inferior to standard transrectal ultrasound guided biopsy for the diagnosis of clinically significant prostate cancer in men without prior biopsy: a study protocol","volume":"7","author":"Kasivisvanathan","year":"2017","journal-title":"BMJ Open"},{"key":"2025121509365004000_13.5.e071191.70","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1097\/JU.0000000000001902","article-title":"Freehand versus GRID-based transperineal prostate biopsy: a comparison of anatomical region yield and complications","volume":"206","author":"Urkmez","year":"2021","journal-title":"J Urol"},{"key":"2025121509365004000_13.5.e071191.71","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1080\/21681805.2021.1933169","article-title":"Rate and characteristics of infection after transrectal prostate biopsy: a retrospective observational study","volume":"55","author":"Forsvall","year":"2021","journal-title":"Scand J Urol"},{"key":"2025121509365004000_13.5.e071191.72","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/21681805.2019.1608295","article-title":"Infections after transrectal ultrasonic guided prostate biopsies-a retrospective study","volume":"53","author":"Danielsen","year":"2019","journal-title":"Scand J Urol"},{"key":"2025121509365004000_13.5.e071191.73","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2004.05096.x"},{"key":"2025121509365004000_13.5.e071191.74","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.05.003"},{"key":"2025121509365004000_13.5.e071191.75","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.eururo.2016.11.017","article-title":"Evaluating the four kallikrein panel of the 4kscore for prediction of high-grade prostate cancer in men in the Canary prostate active surveillance study","volume":"72","author":"Lin","year":"2017","journal-title":"Eur Urol"},{"key":"2025121509365004000_13.5.e071191.76","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"issue":"nov13 3","key":"2025121509365004000_13.5.e071191.77","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g6694","article-title":"Explanatory trials versus pragmatic trials","volume":"349","author":"Sedgwick","year":"2014","journal-title":"BMJ"},{"key":"2025121509365004000_13.5.e071191.78","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.33"},{"key":"2025121509365004000_13.5.e071191.79","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.euo.2021.03.006","article-title":"Limited versus extended pelvic lymph node dissection for prostate cancer: a randomized clinical trial","volume":"4","author":"Touijer","year":"2021","journal-title":"Eur Urol Oncol"},{"key":"2025121509365004000_13.5.e071191.80","doi-asserted-by":"crossref","first-page":"e1016","DOI":"10.1200\/JOP.2016.013474","article-title":"Novel methodology for comparing standard-of-care interventions in patients with cancer","volume":"12","author":"Hilton","year":"2016","journal-title":"J Oncol Pract"},{"key":"2025121509365004000_13.5.e071191.81","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"2025121509365004000_13.5.e071191.82","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-017-2470-1","article-title":"Evaluation of targeted antimicrobial prophylaxis for transrectal ultrasound guided prostate biopsy: a prospective cohort trial","volume":"17","author":"Zembower","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2025121509365004000_13.5.e071191.83","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy584"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-071191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:37:07Z","timestamp":1765820227000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-071191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":83,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,19]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/bmjopen-2022-071191"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-071191","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}