From Brexit to TRexit: Transperineal biopsies pose a challenge to the traditional transrectal biopsy method

By now most of us are familiar with Brexit, the UK’s pending divorce with the European Union. But in a play on that term, British doctors are also moving towards an exit they’ve dubbed “TRexit” from the most common sort of prostate biopsy: the transrectal ultrasound guided biopsy, or TRUS. Men who test positive on the PSA cancer screening test will usually have a prostate biopsy that’s performed in either of two ways. With a TRUS, doctors guided by an ultrasound machine can sample the prostate using a biopsy needle inserted through the rectum. Alternatively, the biopsy needle can be inserted (also under ultrasound guidance) through the perineum, the patch of skin located between the anus and the scrotum. Since it’s traditionally been easier to perform, and less painful for the patient, the TRUS method is preferred globally, accounting for 99% of the estimated one million prostate biopsies performed every year in the United States. But now, UK doctors want to abandon the TRUS for the transperineal method. Why? In short, because TRUS biopsies have been associated with a growing risk of hard-to-treat infections. According to Michael Gross, a researcher in the department of urology at Weill Cornell Medical College in New York, “up to 25% of all men carry antibiotic-resistant strains of E. coli bacteria at biopsy, and those rates are increasing across the country and across the world.” During a TRUS procedure, E. coli and other fecal strains can glom onto the biops...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diagnosis Prostate Knowledge HPK Source Type: blogs