Pfitzinger Paulo Leonardo, Askari Darjusch Andreas, Ivanova Troya, Hoffmann Marina, Blajan Iulia, Atzler Michael, Stadelmeier Leo Federico, Apfelbeck Maria, Chaloupka Michael, Kazmierczak Philipp, Stief Christian, Enzinger Benazir
Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland.
Urologie. 2024 Sep;63(9):934-942. doi: 10.1007/s00120-024-02408-1. Epub 2024 Aug 19.
The prostate biopsy is an essential tool for diagnosing prostate cancer (PCa). While transrectal biopsy (TR-Bx) continues to be considered the gold standard in Germany, the European Association of Urology (EAU) guidelines increasingly recommend transperineal biopsy (TP-Bx) due to lower infection rates and higher tumor detection rates. This article provides an overview of the history and development of the perineal biopsy, compares TR-Bx and TP-Bx and discusses the need for antibiotic prophylaxis before TP-Bx. Current studies have shown that TP-Bx can be performed without antibiotic prophylaxis and new techniques such as robotic-assisted and vector biopsy show very precise results. The establishment of TP-Bx is being promoted by extrabudgetary funding and technological advancements, with the choice of biopsy method remaining an individual decision jointly made in dialogue with the patient.
前列腺活检是诊断前列腺癌(PCa)的重要手段。在德国,经直肠活检(TR-Bx)仍被视为金标准,但由于感染率较低且肿瘤检出率较高,欧洲泌尿外科学会(EAU)指南越来越推荐经会阴活检(TP-Bx)。本文概述了会阴活检的历史和发展,比较了TR-Bx和TP-Bx,并讨论了TP-Bx前预防性使用抗生素的必要性。目前的研究表明,TP-Bx可以在不进行抗生素预防的情况下进行,而机器人辅助活检和向量活检等新技术显示出非常精确的结果。预算外资金和技术进步推动了TP-Bx的应用,活检方法的选择仍是与患者共同商讨后做出的个人决定。