>> Narrator: In-office Ultrasound-guided
Transperineal Prostate Biopsy Explained.
It is common for men with an elevated PSA level
or abnormal prostate exam to undergo a biopsy
to evaluate for the presence of prostate cancer.
A prostate biopsy is performed under ultrasound guidance
and typically involves taking 12 or more samples
of the prostate gland.
In order to visualize the prostate
an ultrasound probe must be placed in the rectum.
Using a guide that is attached to the probe
a biopsy needle is passed through the rectal wall
and into the prostate.
This is repeated for each required sample.
The technical term for this procedure
is a transrectal biopsy.
Transrectal prostate biopsies
can be safely performed in the office setting
with need for only local numbing medicine.
For the last 30 years this has been the most common method
of performing prostate biopsies.
As you can imagine,
passing needles through the rectum and into the prostate
places men at risk of infection
due to the possibility of transferring rectal bacteria
directly into the prostate.
This can range from a simple urinary tract infection
to a life-threatening bloodborne infection
resulting in what is known as sepsis.
To minimize the risk of infection,
urologist commonly prescribed antibiotics to men
undergoing a prostate biopsy.
However, even with the use of antibiotics
infections following a prostate biopsy are relatively common
and can be seen in up to 5% of men
undergoing a transrectal biopsy.
There are also risks associated with receiving antibiotics
such as allergic reactions and upset stomach.
Additionally, the frequent use of antibiotics
can result bacterial resistance.
You may have heard about the emergence
of so-called superbugs in the news.
You're probably wondering,
is there a safer way of performing prostate biopsies?
It turns out there is.
Instead of needles passing through the rectal wall,
they can be passed through an area skin
located between the scrotum and rectum
known as the perineum.
This is called a transperineal biopsy.
When needles are passed through the skin
the risk of infectious complication is greatly minimized,
so much so that no antibiotics are required.
So why isn't this approach routinely used?
The reason is the transperineal technique
has historically been associated
with significant patient discomfort
due to the need for the biopsy needle
to pass through the skin a total of 12 or more times
to obtain the required number of tissue samples.
Because of this,
patients opting for a transperineal biopsy
typically require it to be performed
under general or spinal anesthesia in the operating room.
That was until recently.
Urologist at Johns Hopkins
have adopted a new minimally invasive approach
that allows for transperineal prostate biopsies
to be performed in the office setting
using only local anesthesia.
The key to this procedure is the use of a novel needle guide
that greatly reduces the number of needle passes
through the perineal skin
in order to obtain the required biopsy samples.
This procedure offers the same level of comfort
as the transrectal approach
but with minimal risk of infectious complications,
this without the need for antibiotics.
Physicians at Johns Hopkins
were among the earliest adopters of this procedure
and have extensive experience in safely
and comfortably performing in office
transperineal prostate biopsies.
Contact us today to learn more about this procedure
or to determine if it's right for you.