Patient reported outcome measures for transperineal template prostate mapping biopsies in the PICTURE study
File(s)
Author(s)
Type
Journal Article
Abstract
Purpose:
Transperineal prostate mapping (TTPM) biopsy is an increasingly utilized method of procuring tissue from men with suspected prostate cancer. We sought to report the patient related outcome measures (PROMs) and adverse events in men undergoing this diagnostic test within the PICTURE trial.
Material and Methods:
249 men underwent a mpMRI followed by a TTPM biopsy as a validation study. Pre-and post-TTPM functional outcomes were prospectively collected and recorded using IPSS, IPSS-QoL, IIEF-15 and EPIC-Urinary function questionnaires.
Results:
Mean age, median PSA and median gland size was 62 years, 6.8 ng/ml and 37ml, respectively. At TTPM biopsy, a median (IQR) 49 (40-55) cores were taken. Mean time for completion of post-procedure PROMs questionnaires was 46 days. Adverse events included post procedure acute urinary retention (24%), rectal pain (26%) and perineal pain (41%). TTPM-biopsy resulted in a statistically significant increase in IPSS (10.9 to 11.8; p=0.024) and IPSS-QoL score (1.57 to 1.76; p=0.03). The erectile function score on IIEF-15 declined by 23.2% (47.7 to 38.7; p<0.001). Significant deterioration in all 5 functional domains of IIEF-15 (erectile and orgasmic function, sexual desire, intercourse and overall satisfaction; p<0.001) occurred. EPIC-Urinary scores showed no overall change from baseline.
Conclusions:
TTPM-biopsy causes a high urinary retention rate and a detrimental impact on genitourinary functional outcomes including deterioration in urinary flow and sexual function. Our findings can be used to ensure adequate counselling about TTPM-biopsies and point to a need for strategies such as mpMRI and targeted biopsies to minimize harms of TTPM-biopsy.
Transperineal prostate mapping (TTPM) biopsy is an increasingly utilized method of procuring tissue from men with suspected prostate cancer. We sought to report the patient related outcome measures (PROMs) and adverse events in men undergoing this diagnostic test within the PICTURE trial.
Material and Methods:
249 men underwent a mpMRI followed by a TTPM biopsy as a validation study. Pre-and post-TTPM functional outcomes were prospectively collected and recorded using IPSS, IPSS-QoL, IIEF-15 and EPIC-Urinary function questionnaires.
Results:
Mean age, median PSA and median gland size was 62 years, 6.8 ng/ml and 37ml, respectively. At TTPM biopsy, a median (IQR) 49 (40-55) cores were taken. Mean time for completion of post-procedure PROMs questionnaires was 46 days. Adverse events included post procedure acute urinary retention (24%), rectal pain (26%) and perineal pain (41%). TTPM-biopsy resulted in a statistically significant increase in IPSS (10.9 to 11.8; p=0.024) and IPSS-QoL score (1.57 to 1.76; p=0.03). The erectile function score on IIEF-15 declined by 23.2% (47.7 to 38.7; p<0.001). Significant deterioration in all 5 functional domains of IIEF-15 (erectile and orgasmic function, sexual desire, intercourse and overall satisfaction; p<0.001) occurred. EPIC-Urinary scores showed no overall change from baseline.
Conclusions:
TTPM-biopsy causes a high urinary retention rate and a detrimental impact on genitourinary functional outcomes including deterioration in urinary flow and sexual function. Our findings can be used to ensure adequate counselling about TTPM-biopsies and point to a need for strategies such as mpMRI and targeted biopsies to minimize harms of TTPM-biopsy.
Date Issued
2018-12-01
Date Acceptance
2018-06-15
Citation
Journal of Urology, The, 2018, 200 (6), pp.1235-1240
ISSN
0022-5347
Publisher
Elsevier
Start Page
1235
End Page
1240
Journal / Book Title
Journal of Urology, The
Volume
200
Issue
6
Copyright Statement
© 2018 by American Urological Association Education and Research, Inc. . This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.
Sponsor
Wellcome Trust
University College London Hospitals Charity
Grant Number
204998/Z/16/Z
1348
Subjects
Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
prostatic neoplasms
image-guided biopsy
magnetic resonance imaging
patient reported outcome measures
complications
MULTI-PARAMETRIC MRI
DIAGNOSTIC-ACCURACY
CANCER
UROLOGY
CORES
complications
image-guided biopsy
magnetic resonance imaging
patient reported outcome measures
prostatic neoplasms
Aged
Biopsy, Large-Core Needle
Erectile Dysfunction
Humans
Image Processing, Computer-Assisted
Image-Guided Biopsy
Magnetic Resonance Imaging, Interventional
Male
Middle Aged
Pain, Procedural
Patient Reported Outcome Measures
Perineum
Postoperative Complications
Prospective Studies
Prostate
Prostatic Neoplasms
Quality of Life
Ultrasonography, Interventional
Urinary Retention
1103 Clinical Sciences
Urology & Nephrology
Publication Status
Published
Date Publish Online
2018-06-27