Improving the safety and tolerability of local anaesthetic outpatient transperineal prostate biopsies: A pilot study of the CAMbridge PROstate Biopsy (CAMPROBE) method. (May 2018)

• Record Type: Journal Article
• Authors: Thurtle, D; Starling, L; Leonard, K; Stone, T; Gnanapragasam, VJ
• Is Part Of: Journal of clinical urology. Volume 11:Number 3(2018)
• Page Start: 192
• Page End: 199
• Publication Date: 2018-05
• Subjects: Prostate cancer -- transperineal biopsy -- diagnostic intervention -- patient safety -- service delivery; Genitourinary organs -- Surgery -- Periodicals; Genitourinary organs -- Diseases -- Periodicals; Urology -- Periodicals; 616.6005
• DOI: 10.1177/2051415818762683
• Languages: English
• ISSNs: 2051-4158

Abstract

Objectives: The aim of this study was to pilot the use of a bespoke device (CAMPROBE, the CAMbridge PROstate Biopsy) to enable routine outpatient free-hand local anaesthetic (LA) transperineal prostate biopsies. Materials and methods: The CAMPROBE prototype was designed and built in our institution. Men on active surveillance due prostate resampling were invited to have a CAMPROBE biopsy as an alternative to repeat transrectal ultrasound-guided prostate biopsies (TRUSBx) as part of an approved trial (NCT02375035). Biopsies were performed using LA infiltration only, without sedation or additional analgesia. Patient-reported outcomes were recorded at day 0 and 7 using validated questionnaires and visual analogue scales (VAS). Complications were recorded prospectively. Results: Thirty men underwent biopsies with a median of 11 cores taken per procedure (interquartile range 10–12). There were no infections, sepsis or retention episodes. Haematuria and haematospermia occurred in 67% and 62% of patients, which are similar to rates reported for TRUSBx. Mean VAS for pain (0–10 scale) was less than 3 for every part of the procedure. All 30 men described the procedure as tolerable under LA. In total, 26/30 (86.7%) men expressed a preference for a CAMPROBE procedure over TRUSBx and a further 3 (10.0%) would have either. Conclusions: In this small pilot study, the CAMPROBE device and method appears to be a safe, simple and well-tolerated out-patient transperineal replacement for TRUSBx. A major new National Institute for Health Research grant will allow its further development from a prototype to a single use, low-cost disposable device ready for multi-centre testing. Level of evidence: 1b: individual cohort study.