A NEW technique for collecting prostate biopsy samples reduced the risk of infection compared with traditional biopsy approaches. This procedure, which involves inserting a needle through the perineum to collect prostate tissue, avoids the higher infection risks associated with the transrectal method.
The PREVENT trial compared the two biopsy techniques in 752 men across multiple U.S. medical centres. Men undergoing the transperineal biopsy received no antibiotics, while those in the transrectal group were given targeted antibiotics. Despite these precautions, six men in the transrectal group developed infections, while none were reported in the transperineal group. This finding is notable because approximately 90% of prostate biopsies in the U.S. are currently performed transrectally, with an infection rate of 5%-7%.
In conclusion, the transperineal biopsy technique not only eliminates infection risk but reduces the need for prophylactic antibiotics, thus addressing the broader concern of antibiotic resistance. A shift towards this method could follow the example of Norway, where a nationwide switch significantly reduced biopsy-related infections. Moving forward, emphasis on physician training and policy changes will be key to integrating this safer procedure into mainstream clinical practice.
Katrina Thornber, EMJ
Reference
Hu JC et al. Transperineal vs Transrectal Prostate Biopsy-The PREVENT Randomized Clinical Trial. JAMA Oncol. 2024;DOI:10.1001/jamaoncol.2024.4000.
