Prostate Biopsy Procedure Eliminates Risk of Infection

Urologists at Northwell Health’s Smith Institute for Urology recently started offering a new biopsy procedure which samples tissue from the prostate to potentially detect cancer — and eliminates the risk of infection.

The procedure, known as a transperineal biopsy, is an important step forward for prostate health because it avoids risk of infection by inserting needles into the perineum to reach the prostate. The standard technique, transrectal biopsy, guides the needles through the rectal wall, where fecal bacteria can cause contamination.

“We are looking at the transperineal biopsy because transrectal procedure has a history of causing sepsis, with up to five percent of men getting infections, which has been cited in scientific urologic literature nationally for decades,” said Michael Schwartz, MD, director of laparoscopic and robotic surgery at the Smith Institute for Urology. “Patients with these infections need to be hospitalized and require intravenous antibiotics. The transperineal biopsy is a huge advantage and offers patients a safe alternative with a virtually zero risk of infection.”

Dr. Schwartz said the transperineal biopsy, which takes about 10 to 15 minutes, is performed in an outpatient setting under local anesthesia. Using the standard rectal ultrasound, the new technology allows physicians to pass a needle through the perineum and perform multiple biopsies through one entry and easier access to certain areas of the prostate.

“Taking away the infection risk in the biopsy procedure is a game changer,” said Louis Kavoussi, MD, chair of urology at Northwell Health. “Approximately 30% to 40% of patients we treat with low-grade prostate cancer are under surveillance. This means men must have biopsies every couple of years. Patients are always concerned about how they can reduce their risk for infections and this new method removes barriers to care.”

The Smith Institute of Urology is among a handful of institutions in the nation offering the transperineal prostate biopsy along with urologists in other countries. Dr. Schwartz said the urology institute anticipates performing 500-600 transperineal biopsies each year. He said the new, safer procedure is “a wave that has come to urology” and will likely be commonplace in five years.

September is Prostate Cancer Awareness Month. Prostate cancer affects one in six men in the US. Urologists recommend men between the ages of 50 and 75 get a prostate screening, which includes a discussion with a physician, a prostate-specific antigen (PSA) blood test and prostate exam. Other things that can increase your risk for prostate cancer include your family history and geography and ethnic background.

For more information, call the Smith Institute for Urology at 516-734-8500.