{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:51:05Z","timestamp":1781542265638,"version":"3.54.5"},"reference-count":39,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Introduction: To evaluate the use of transcutaneous perineal ultrasound to guide prostate biopsy in men previously submitted to rectal amputation.Materials and Methods: From January 2018 to January 2025, 10 men aged between 47 and 76 years (median age: 56 years) previously submitted to proctocolectomy (7 men for rectum cancer and 3 men for benign disease) were evaluated for the suspicion of prostate cancer (PCa). The indications for biopsy were PSA &gt;10 ng\/mL or PSA values between 4.1-10 ng\/mL with free\/total PSA &lt;25% and\/or PSA density &gt;0.20. All the patients submitted for the first time to biopsy underwent extended scheme (ePBx: 12-18 cores); in addition, all the patients underwent multiparametric magnetic resonance (mpMRI) and in the presence of a Prostate Imaging-Reporting and Data System-version 2 (PI-RADS) score \u22653 a cognitive targeted biopsy (TPBx:\u00a0 4 cores) was added to the systematic prostate biopsy. Biopsies were freehand using 18-gauge automatic biopsy needles under perineal real-time ultrasound guidance (3.5 MHz convex probe).Results: Median PSA was 9.7 (range: 4.8-27 ng\/mL); in 1\/10 (10%) patient mpMRI was negative, conversely in 3 (30%) vs 3 (30%) vs 3 (30%) men, PIRADS score was 3 vs 4 vs\u00a05, respectively. Overall, a csPCa (ISUPGrade Group &gt; 2\/Gleason score &gt; 3+4) was found in 5\/10 (50%) patients; PCa was located in the peripheric zone in 4 (80%) cases and 1 (20%) case in the anterior zone of the gland. In detail, ePBx vs. TPBx biopsies diagnosed 5\/5 (100%) and 4\/5 (90%) csPCa. One patient diagnosed with csPCa had negative mpMRI, 1 and 3 men had PIRADS score 4 and 5, respectively. None had clinical complications that needed hospital admission.Conclusions: Transcutaneous perineal ultrasound-guided prostate biopsy allows for the performance of accurate systematic and targeted biopsies in men with suspicious PCa previously submitted to rectal amputation.<\/jats:p>","DOI":"10.4081\/aiua.2025.14047","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T13:35:53Z","timestamp":1753104953000},"source":"Crossref","is-referenced-by-count":2,"title":["Transcutaneous perineal-ultrasound guided prostate biopsy in men with rectal amputation"],"prefix":"10.4081","volume":"97","author":[{"given":"Pietro","family":"Pepe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovica","family":"Pepe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-1761","authenticated-orcid":false,"given":"Vincenzo","family":"Fiorentino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Curduman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Fraggetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"187707","doi-asserted-by":"crossref","unstructured":"Bergengren O, Pekala KR, Matsoukas K, et al. Update on prostate cancer epidemiology and risk factors-a systematic review. Eur Urol 2023; 84:191-206.","DOI":"10.1016\/j.eururo.2023.04.021"},{"key":"187708","doi-asserted-by":"crossref","unstructured":"Pepe P, Pennisi M. Morbidity following transperineal prostate biopsy: Our experience in 8.500 men. Arch Ital Urol Androl 2022;94:155-159.","DOI":"10.4081\/aiua.2022.2.155"},{"key":"187709","doi-asserted-by":"crossref","unstructured":"Derin O, Fonseca L, Sanchez-Salas R, Roberts MJ. Infectious complications of prostate biopsy: winning battles but not war. World J Urol 2020; 38:2743-2753.","DOI":"10.1007\/s00345-020-03112-3"},{"key":"187710","doi-asserted-by":"crossref","unstructured":"Pepe P, Dibenedetto G, Pennisi M, et al. Detection rate of anterior prostate cancer in 226 patients submitted to initial and repeat transperineal biopsy. Urol Int 2014; 93:189-192.","DOI":"10.1159\/000358494"},{"key":"187711","doi-asserted-by":"crossref","unstructured":"Pepe P, Roscigno M, Pepe L, et al. Could 68Ga-PSMA PET\/CT evaluation reduce the number of scheduled prostate biopsies in men enrolled in active surveillance protocols? J Clin Med. 2022; 11:3473.","DOI":"10.3390\/jcm11123473"},{"key":"187712","doi-asserted-by":"crossref","unstructured":"Pepe P, Cimino S, Garufi A, et al. Confirmatory biopsy of men under active surveillance: extended versus saturation versus multiparametric magnetic resonance imaging\/transrectal ultrasound fusion prostate biopsy. Scand J Urol 2017; 51:260-263.","DOI":"10.1080\/21681805.2017.1313310"},{"key":"187713","doi-asserted-by":"crossref","unstructured":"Filderman PS, Jacobs SC. Prostatic ultrasound in the patient without a rectum. Urology 1994; 43:722-724.","DOI":"10.1016\/0090-4295(94)90197-X"},{"key":"187714","doi-asserted-by":"crossref","unstructured":"Schapira HE: Prostatic needle biopsy in patients after abdominoperineal resection. Urology 1982; 20:76-77.","DOI":"10.1016\/0090-4295(82)90544-1"},{"key":"187715","doi-asserted-by":"crossref","unstructured":"McNicholas DP, Parr NJ. Image intensifier-guided transperineal prostate biopsy for patients without a rectum: novel technique. BJU Int 2024; 133:487-490.","DOI":"10.1111\/bju.16279"},{"key":"187716","doi-asserted-by":"crossref","unstructured":"Aragona F, Pepe P, Motta M, et al. Incidence of prostate cancer in Sicily: results of a multicenter case-findings protocol. Eur Urol 2005;47:569-74.","DOI":"10.1016\/j.eururo.2004.11.007"},{"key":"187717","doi-asserted-by":"crossref","unstructured":"Pepe P, Aragona F. Incidence of insignificant prostate cancer using free\/total PSA: results of a case-finding protocol on 14,453 patients. Prostate Cancer Prostatic Dis. 2010; 13:316-319.","DOI":"10.1038\/pcan.2010.29"},{"key":"187718","doi-asserted-by":"crossref","unstructured":"Roscigno M, Stabile A, Lughezzani G, et al The use of multiparametric magnetic resonance imaging for follow-up of patients included in active surveillance protocol. Can PSA density discriminate patients at different risk of reclassification? Clin Genitourin Cancer 2020; 18:e698-e704.","DOI":"10.1016\/j.clgc.2020.04.006"},{"key":"187719","doi-asserted-by":"crossref","unstructured":"Pepe P, D'Urso D, Garufi A, et al. Multiparametric MRI apparent diffusion coefficient (ADC) accuracy in diagnosing clinically significant prostate cancer. In Vivo 2017; 31:415-418.","DOI":"10.21873\/invivo.11075"},{"key":"187720","doi-asserted-by":"crossref","unstructured":"Pepe P, Aragona F. Prostate needle biopsy: 12 vs. 18 cores - is it necessary? Urol Int 2005; 74:19-22.","DOI":"10.1159\/000082703"},{"key":"187721","doi-asserted-by":"crossref","unstructured":"Pepe P, Pennisi M, Fraggetta F. How many cores should be obtained during saturation biopsy in the era of multiparametric magnetic resonance? Experience in 875 patients submitted to repeat prostate biopsy. Urology 2020; 137:133-137.","DOI":"10.1016\/j.urology.2019.11.016"},{"key":"187722","doi-asserted-by":"crossref","unstructured":"Pepe P, Dibenedetto G, Pepe L, Pennisi M. Multiparametric MRI versus SelectMDx accuracy in the diagnosis of clinically significant PCa in men enrolled in active surveillance. In Vivo 2020; 34:393-396.","DOI":"10.21873\/invivo.11786"},{"key":"187723","doi-asserted-by":"crossref","unstructured":"Pepe P, Pennisi M. Targeted biopsy in men high risk for prostate cancer: 68Ga-PSMA PET\/CT versus mpMRI. Clin Genitourin Cancer 2023; 21: 639-642.","DOI":"10.1016\/j.clgc.2023.06.007"},{"key":"187724","doi-asserted-by":"crossref","unstructured":"Pepe P, Pepe L, Tamburo M, et al. 68Ga-PSMA PET\/CT and prostate cancer diagnosis: which SUVmax value? In Vivo 2023;37:1318-1322.","DOI":"10.21873\/invivo.13211"},{"key":"187725","doi-asserted-by":"crossref","unstructured":"Pepe P, Pepe L, Tamburo M, et al. 68Ga-PSMA PET\/CT evaluation in men enrolled in prostate cancer Active Surveillance. Arch Ital Urol Androl. 2023; 95:11322.","DOI":"10.4081\/aiua.2023.11322"},{"key":"187726","doi-asserted-by":"crossref","unstructured":"Pepe P, Fraggetta F, Galia A, et al. PCA3 score and prostate cancer diagnosis at repeated saturation biopsy. Which cut-off: 20 or 35? Int Braz J Urol 2012; 38:489-995.","DOI":"10.1590\/S1677-55382012000400008"},{"key":"187727","unstructured":"Pepe P, Aragona F. PCA3 score vs PSA free\/total accuracy in"},{"key":"187728","unstructured":"prostate cancer diagnosis at repeat saturation biopsy. Anticancer Res 2011; 31:4445-4449."},{"key":"187729","doi-asserted-by":"crossref","unstructured":"Salemi M, Pettinato A, Fraggetta F, et al. Expression of miR-132 and miR-212 in prostate cancer and metastatic lymph node: Case report and revision of the literature. Arch Ital Urol Androl 2020;92:209-210.","DOI":"10.4081\/aiua.2020.3.209"},{"key":"187730","doi-asserted-by":"crossref","unstructured":"Fiorentino V, Pepe L, Pizzimenti C, et al. PD-L1 expression in prostate cancer and Gleason Grade Group: Is there any relationship? Findings from a multi-institutional cohort. Pathol Res Pract. 2025; 269:155916.","DOI":"10.1016\/j.prp.2025.155916"},{"key":"187731","doi-asserted-by":"crossref","unstructured":"Fiorentino V, Martini M, Dell'Aquila M, et al. Histopathological ratios to predict Gleason score agreement between biopsy and radical prostatectomy. Diagnostics (Basel) 2020; 11:10.","DOI":"10.3390\/diagnostics11010010"},{"key":"187732","doi-asserted-by":"crossref","unstructured":"Pepe P, Pepe L, Panella P, Pennisi M. Can multiparametric ultrasound improve cognitive MRI\/TRUS fusion prostate biopsy. Arch Ital Urol Androl. 2020; 92:89-92.","DOI":"10.4081\/aiua.2020.2.89"},{"key":"187733","doi-asserted-by":"crossref","unstructured":"Pepe P, Pepe L, Tamburo M, et al. Targeted prostate biopsy: 68Ga-PSMA PET\/CT vs. mpMRI in the diagnosis of prostate cancer. Arch Ital Urol Androl 2022; 94:274-277.","DOI":"10.4081\/aiua.2022.3.274"},{"key":"187734","doi-asserted-by":"crossref","unstructured":"Patel N, Coakley FV, Foster BR. Performance of transgluteal CTguided biopsy of prostate lesions in men without rectal access: A retrospective study. Clin Imaging 2021; 79:225-229.","DOI":"10.1016\/j.clinimag.2021.06.004"},{"key":"187735","doi-asserted-by":"crossref","unstructured":"Amin A, Blazevski A, Scheltema M, Stricker P. Transperineal biopsy of the prostate in a patient post abdominoperineal resection. Urol Case Rep. 2019; 28:101055.","DOI":"10.1016\/j.eucr.2019.101055"},{"key":"187736","doi-asserted-by":"crossref","unstructured":"Park BK, Chung JH, Song W, et al. New transperineal ultrasound-guided biopsy for men in whom PSA is increasing after Miles' operation. Insights Imaging. 2023; 14:42.","DOI":"10.1186\/s13244-023-01384-y"},{"key":"187737","doi-asserted-by":"crossref","unstructured":"Seaman EK, Sawczuk IS, Fatal M, et al. Transperineal prostate needle biopsy guided by transurethral ultrasound in patients without a rectum. Urology 1996; 47:353-355.","DOI":"10.1016\/S0090-4295(99)80452-X"},{"key":"187738","doi-asserted-by":"crossref","unstructured":"Pepe P, Pepe L, Fiorentino V, et al. Multiparametric MRI targeted biopsy: when omit systematic biopsy? Arch Ital Urol Androl 2024;96:12992.","DOI":"10.4081\/aiua.2024.12992"},{"key":"187739","doi-asserted-by":"crossref","unstructured":"Caputo A, Maffei E, Gupta N, et al. Computer-assisted diagnosis to improve diagnostic pathology: a review. Indian J Pathol Microbiol. 2025; 68:3-10.","DOI":"10.4103\/ijpm.ijpm_339_24"},{"key":"187740","doi-asserted-by":"crossref","unstructured":"Str\u00f6m P, Kartasalo K, Olsson H, et al. Artificial intelligence for diagnosis and grading of prostate cancer in biopsies: a populationbased, diagnostic study. Lancet Oncol. 2020; 21:222-232.","DOI":"10.1016\/S1470-2045(19)30738-7"},{"key":"187741","doi-asserted-by":"crossref","unstructured":"Vatrano S, Pepe P, Pepe L, et al. BRCA mutations and prostate cancer: should urologist improve daily clinical practice? Arch Ital Urol Androl. 2025:13635.","DOI":"10.4081\/aiua.2025.13635"},{"key":"187742","doi-asserted-by":"crossref","unstructured":"Pecci V, Troisi F, Aiello A, et al. Targeting of H19\/cell adhesion molecules circuitry by GSK-J4 epidrug inhibits metastatic progression in prostate cancer. Cancer Cell Int. 2024; 24:56.","DOI":"10.1186\/s12935-024-03231-6"},{"key":"187743","doi-asserted-by":"crossref","unstructured":"Kinnaird A, Luger F, Cash H, et al. Microultrasonography-guided vs MRI-guided biopsy for prostate cancer diagnosis: The OPTIMUM randomized clinical trial. JAMA 2025;333:1679-1687.","DOI":"10.1001\/jama.2025.3579"},{"key":"187744","doi-asserted-by":"crossref","unstructured":"Fandella A, Scattoni V, Galosi A, et al. Italian Prostate biopsies group: 2016 updated guidelines insights. Anticancer Res. 2017; 37:413-424.","DOI":"10.21873\/anticanres.11333"},{"key":"187745","doi-asserted-by":"crossref","unstructured":"Xiao Y, Zeng Y, Han L, et al. A novel simplified transperineal prostate biopsy guided by perineal ultrasound. Br J Radiol 2024;97:1351-1356.","DOI":"10.1093\/bjr\/tqae097"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/14047\/13284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/14047\/13284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T09:39:07Z","timestamp":1759311547000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/14047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,21]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,30]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2025.14047","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7,21]]}}}