Introduction

1. No. 169 Complications after prostate biopsy: a meta-analysis of transrectal prostate biopsy versus transperineal prostate biopsy Matthew Winter1, Philip Bergersen1, Henry H Woo2,3, Venu Chalasani1,2,3 Northern Sydney Local Health District /Hornsby Ku-ring-gai Hospital University of Sydney Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group Ltd Posters Proudly Supported by: Introduction Two established techniques of prostate biopsy exist: the more commonly used transrectal (TR) approach and the transperineal (TP) approach. By avoiding traversing the rectum, the TP approach is thought to reduce infectious complications. • Results • Four studies were identified with 850 patients in total (1-4). • No significant heterogeneity was noted between trials. Aim To conduct a systematic review and meta-analysis to determine if any difference in complication rate exists between TR and TP prostate biopsy. • Methods • Biomedical databases from 1946 to 2012 in Medline, Embase, and Cochrane Central Register of Controlled Trial were searched, as were conference proceedings for the EAU, AUA, and BAUS over the past 10 years. • Studies were included if they were randomised controlled trials (RCTs)comparing TR to TP prostate biopsy. • Meta-analysis was performed using a fixed effects model. Risk ratio (RR) and its 95% confidence interval were calculated. • A RR of less than 1 favoured fewer complications with TR prostate biopsy, whilst a RR of greater than 1 indicated more complications with TR prostate biopsy. Table 1. Complication incidence and risk ratio of transrectal and transperineal prostate biopsy. • Conclusions • No statistical difference in complication rate was found between TR and TP prostate biopsy. • A trend towards rectal bleeding, infectious complications, urinary retention, and vasovagal events was more frequently reported during the TR approach. • A trend towards haematuria and haematospermia was more frequently reported during the TP approach. • Larger RCTs are needed to demonstrate a difference in complication rates. Figure 1. Forest plot of infectious complications following transrectal and transperineal prostate biopsy. References Cerruto MA, Novella G, Vianello F and Zattoni F: Transrectal versus transperineal 14-core prostate biopsy in detection of prostate cancer: A comparative evaluation at the same Institution. European Urology Supplements. 9 (2): 85, 2010 Chae Y, Kim YJ, Kim T, Yun SJ, Lee SC and Kim WJ: The comparison between transperineal and transrectal ultrasound-guided prostate needle biopsy. Korean Journal of Urology. 50 (2) (pp 119-124), 2009. February 2009. Hara R, Jo Y, Fujii T, Kondo N, Yokoyoma T, Miyaji Y and Nagai A: Optimal approach for prostate cancer detection as initial biopsy: prospective randomized study comparing transperineal versus transrectal systematic 12-core biopsy. Urology. 71: 191-5, 2008. Takenaka A, Hara R, Ishimura T, Fujii T, Jo Y, Nagai A and Fujisawa M: A prospective randomized comparison of diagnostic efficacy between transperineal and transrectal 12-core prostate biopsy. Prostate Cancer Prostatic Dis. 11: 134-8, 2008. • Acknowledgements • Special thanks to Maria Cerruto for personal communications and additional data.