Safety profile of robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate

Manuel Walter; Pawel Trotsenko; Hanns-Christian Breit; Nicola Keller; Anja Meyer; David Jean Winkel; Hans Helge Seifert; Christian Wetterauer

doi:10.3389/fonc.2022.1025355

Safety profile of robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate

Front Oncol. 2022 Dec 1:12:1025355. doi: 10.3389/fonc.2022.1025355. eCollection 2022.

Authors

Manuel Walter¹, Pawel Trotsenko¹, Hanns-Christian Breit², Nicola Keller³, Anja Meyer¹, David Jean Winkel², Hans Helge Seifert¹, Christian Wetterauer^{1

3

4}

Affiliations

¹ Department of Urology, University Hospital Basel, Basel, Switzerland.
² Department of Radiology, University Hospital Basel, Basel, Switzerland.
³ University of Basel, Basel, Switzerland.
⁴ Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria.

Abstract

Introduction: Robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate is a novel and highly accurate procedure. The aim of this study was to evaluate the MonaLisa prostate biopsy system in terms of safety, tolerability, and patient-related outcomes.

Methods: This prospective study included 228 patients, who had undergone Robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate at the University Hospital Basel between January 2020 and June 2022. Peri-operative side effects, functional outcomes and patient satisfaction were assessed.

Results: Mean pain score on the day of biopsy was 1.3 points on VAS, which remained constant on the day after biopsy. Overall, 32 of 228 patients (14%) developed grade I complications according to Clavien-Dindo classification. No higher-grade complications occurred. Gross haematuria, hematospermia and acute urinary retention occurred in 145/228 (63.6%), 98/228 (43%) and 32/228 (14%) patients, respectively. One patient (0.4%) developed urinary tract infection.

Conclusions: Robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate performed under general anesthesia is a safe and well tolerated procedure. This technique allows to omit perioperative prophylaxis and at the same time minimizes the risk of infectious complications. We attribute the favorable risk profile and tolerability to the minimal invasive approach via two entry points.

Keywords: biopsy; prostate; robotic-assisted; safety; transperineal.