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World Journal of Urology

, Volume 37, Issue 2, pp 337–342 | Cite as

Factors influencing urinary retention after transperineal template biopsy of the prostate: outcomes from a regional cancer centre

  • Francesca KumEmail author
  • Adam Jones
  • Raj Nigam
Original Article
  • 51 Downloads

Abstract

Introduction

Multi-parametric MRI (MP-MRI) prior to prostate biopsy is the investigation of choice for an elevated age-related PSA and abnormal digital rectal examination. MP-MRI in combination with transperineal template mapping biopsy has facilitated the development of the concept of targeted biopsies, either cognitively or with software fusion. Urinary retention is a recognised complication of transperineal prostate biopsy, with reported incidence being 1.6–11.4%. We present patient and procedure-related factors, which influence occurrence of urinary retention after transperineal template biopsy.

Patients and methods

Retrospective data collection of 243 consecutive cases of transperineal template biopsies performed at a single institution were recorded and analysed. Biopsies were taken using a standard 5-mm template in 4–6 sectors, depending on the prostate volume.

Results

31/243 (12.8%) patients developed urinary retention, defined as patient discomfort and inability to micturate and bladder scan of ≥ 600 ml. Patients in the retention group were significantly older (mean 68.7 vs. 65.8 years, P = 0.034). Prostate volume was significantly greater in comparison with the non-retention group (mean 75.4 vs. 57.2 cc, P = 0.0016). The number of biopsies taken was positively correlated with urinary retention (median 35 vs. 32 biopsies, P = 0.045), and this was independent of prostate size (R2 = 0.2). Presenting PSA, pre-operative flow and histopathological outcome were independent of urinary retention.

Conclusions

Factors resulting in an increased risk of urinary retention are advancing age (> 68.7 years); a larger prostate volume (> 75 cc); greater number of biopsies (> 35); greater severity of lower urinary tract symptoms prior to biopsy and diabetes. Targeted biopsies alone, instead of a full template, may avoid urinary retention in the high-risk groups identified.

Keywords

Transperineal template biopsy Prostate biopsy Prostate cancer Urinary retention 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology (c/o Mr Raj Nigam)Royal Surrey County HospitalGuildfordUK

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