Transrectal Prostate Biopsy Approach in Men Undergoing Kidney Transplant: A Retrospective Cohort Study at Three Referral Academic Centers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Selection Criteria
2.2. Treatment Protocols
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patients’ Characteristics | Group 1 TR-PB US Standard n: 59 | Group 2 TR-PB MRI-US Cognitive n: 62 | p Value |
Age (years): | 63.5 (47.7–78.9) | 65.2 (51.3–77.7) | NS |
1st degree positive family history, n (%): | 9 (15.2) | 11 (17.7) | NS |
Race, n (%): | |||
African | 1 (1.7) | 0 | NS |
American | 0 | 1 (1.6) | NS |
Asian | 1 (1.7) | 1 (1.6) | NS |
Caucasian | 57 (96.6) | 60 (96.8) | NS |
PSA levels ng/mL, median (IQR): | 6.7 (2.8–15.3) | 7.9 (3.2–17.4) | NS |
Prostate volume mL, median (IQR): | 58.3 (22–84) | 57.2 (21–87) | NS |
Positive/suspicious DRE, n (%): | 34 (57.6) | 38 (61.3) | NS |
Comorbidities, n (%): | |||
Diabetes mellitus | 8 (13.5) | 15 (24.2) | <0.001 |
Cardiovascular disease (not hypertension) | 11 (18.6) | 13 (20.9) | NS |
Hemorrhoids | 19 (32.2) | 9 (14.5) | <0.001 |
Antiplatelet/anticoagulant drugs, n (%): | |||
Suspended before TR-PB | 19 (32.2) | 21 (33.9) | NS |
Not suspended before TR-PB | 11 (18.6) | 13 (20.9) | NS |
Transplant and Kidney Failure Features | Group 1 TR-PB US Standard n: 59 | Group 2 TR-PB MRI-US Cognitive n: 62 | p Value |
Renal function at TR-PB, median (IQR): | |||
Creatinine mg/dL | 1.7 (1.19–2.41) | 1.6 (1.24–2.39) | NS |
eGFR mL/min | 46.8 (31.6–64.5) | 45.8 (32.3–63.7) | NS |
Cause of renal failure, n (%): | |||
Chronic glomerulonephritis | 23 (39) | 21 (33.9) | <0.001 |
APKD | 14 (23.7) | 16 (25.8) | NS |
Diabetic nephropathy | 8 (13.5) | 15 (24.2) | <0.001 |
Nephrosclerosis | 4 (6.8) | 6 (9.7) | NS |
Chronic pyelonephritis | 1 (1.7) | 2 (3.2) | NS |
Congenital renal dysplasia | 0 | 1 (1.6) | NS |
Others | 1 (1.7) | 1 (1.6) | NS |
Number of kidney transplants, n (%): | |||
1 | 57 (96.6) | 59 (95.1) | NS |
2 | 2 (3.4) | 3 (4.9) | NS |
Type of first transplant, n (%): | |||
Single cadaver | 57 (96.6) | 59 (95.2) | NS |
Single living donor | 1 (1.7) | 2 (3.2) | NS |
Double cadaver | 1 (1.7) | 1 (1.6) | NS |
Features of the Biopsy and Cancer Detection Rate | Group 1 TR-PB US Standard n: 59 | Group 2 TR-PB MRI-US Cognitive n: 62 | p Value |
Indication for biopsy, n (%): | |||
Biopsy naìve | 43 (72.9) | 45 (72.6) | NS |
Surveillance | 2 (3.4) | 1 (1.6) | NS |
Prior negative biopsy | 14 (23.7) | 16 (25.8) | NS |
Location of index lesion (MRI/US), n (%): | |||
Peripheral zone | 53 (89.9) | 51 (82.3) | NS |
Transition zone | 6 (10.1) | 11 (17.7) | <0.001 |
PI-RADS, n (%): | |||
<3 | - | 0 | |
3 | - | 37 (59.7) | |
4–5 | - | 25 (40.3) | |
Total number of targeted cores, n: | 236 | 279 | NS |
Number of positive targeted cores, n (%): | 65 (27.5) | 97 (34.7) | <0.001 |
Biopsy ISUP grade, n (%): | |||
GG1 | 14 (23.7) | 16 (25.8) | NS |
GG2 | 6 (10.1) | 8 (12.9) | NS |
GG3 | 3 (5.1) | 1 (1.6) | NS |
GG4 | 1 (1.7) | 1 (1.6) | NS |
GG5 | 0 | 0 | NS |
ASAP, n (%): | 2 (3.4) | 1 (1.6) | NS |
HG-PIN, n (%): | 1 (1.7) | 2 (3.2) | NS |
Side Effects | Group 1 TR-PB US Standard n: 59 | Group 2 TR-PB MRI-US Cognitive n: 62 | p Value |
Early side effects (days 1–7), n (%): | |||
Pain requiring analgesics | 2 (3.4) | 1 (1.6) | NS |
Hematuria | 7 (11.9) | 9 (14.5) | NS |
Rectal bleeding | 6 (10.2) | 1 (1.6) | <0.001 |
Urinary tract infections | 3 (5.1) | 2 (3.2) | NS |
Acute urinary retention | 2 (3.4) | 2 (3.2) | NS |
Sepsis | 0 | 0 | NS |
Late side effects (days 7–15), n (%): | |||
Pain requiring analgesics | 0 | 0 | NS |
Hematuria | 2 (3.4) | 1 (1.6) | NS |
Rectal bleeding | 0 | 0 | NS |
Urinary tract infections | 1 (1.7) | 1(1.6) | NS |
Acute urinary retention | 1 (1.7) | 1 (1.6) | NS |
Sepsis | 0 | 0 | NS |
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Dell’Atti, L.; Slyusar, V.; Ronchi, P.; Manno, S.; Cambise, C. Transrectal Prostate Biopsy Approach in Men Undergoing Kidney Transplant: A Retrospective Cohort Study at Three Referral Academic Centers. Diagnostics 2024, 14, 266. https://doi.org/10.3390/diagnostics14030266
Dell’Atti L, Slyusar V, Ronchi P, Manno S, Cambise C. Transrectal Prostate Biopsy Approach in Men Undergoing Kidney Transplant: A Retrospective Cohort Study at Three Referral Academic Centers. Diagnostics. 2024; 14(3):266. https://doi.org/10.3390/diagnostics14030266
Chicago/Turabian StyleDell’Atti, Lucio, Viktoria Slyusar, Piero Ronchi, Stefano Manno, and Chiara Cambise. 2024. "Transrectal Prostate Biopsy Approach in Men Undergoing Kidney Transplant: A Retrospective Cohort Study at Three Referral Academic Centers" Diagnostics 14, no. 3: 266. https://doi.org/10.3390/diagnostics14030266