Improving the Safety and Tolerability of Local Anaesthetic Outpatient Transperineal Prostate Biopsies: A Pilot Study of the CAMbridge PROstate Biopsy (CAMPROBE) Method
The CAMPROBE prototype was designed and built in our institution. Men on active surveillance due prostate resampling were invited to have a CAMPROBE biopsy as an alternative to repeat transrectal ultrasound-guided prostate biopsies (TRUSBx) as part of an approved trial (NCT02375035). Biopsies were performed using LA infiltration only, without sedation or additional analgesia. Patient-reported outcomes were recorded at day 0 and 7 using validated questionnaires and visual analog scales (VAS). Complications were recorded prospectively.
Thirty men underwent biopsies with a median of 11 cores taken per procedure (interquartile range 10–12). There were no infections, sepsis or retention episodes. Haematuria and haematospermia occurred in 67% and 62% of patients, which are similar to rates reported for TRUSBx. Mean VAS for pain (0–10 scale) was less than 3 for every part of the procedure. All 30 men described the procedure as tolerable under LA. In total, 26/30 (86.7%) men expressed a preference for a CAMPROBE procedure over TRUSBx and a further 3 (10.0%) would have either.
In this small pilot study, the CAMPROBE device and method appears to be a safe, simple and well-tolerated out-patient transperineal replacement for TRUSBx. A major new National Institute for Health Research grant will allow its further development from a prototype to a single use, low-cost disposable device ready for multi-centre testing.
Written by: D Thurtle1,2, L Starling1,2,3, K Leonard1,2,3, T Stone4 and VJ Gnanapragasam1,2,3
1. Academic Urology Group, University of Cambridge, Cambridge, UK
2. Department of Urology, Addenbrooke’s Hospital, Cambridge, UK
3. Cambridge Urology Translational Research and Clinical Trials, University of Cambridge, Cambridge, UK
4. Medical Physics and Clinical Engineering, Addenbrooke’s Hospital, Cambridge, UK
Go Beyond the Abstract and Read a Commentary by the Author: Vincent J Gnanapragasam, BMedSci MA Ph.D. FRCS FRCSEdUrol
Journal of Clinical Urology 2018, Vol. 11(3) 192–199 © British Association of Urological Surgeons 2018, First Published March 5, 2018, https://doi.org/10.1177/2051415818762683