Login to Access Video or Poster Abstract: MP77-09
Sources of Funding: None

Introduction

The diagnostic work-up of prostate cancer has experienced a rapid shift worldwide in recent years. This study aims to provide a current appraisal of the practice of prostate biopsy in Australia and New Zealand in the emerging era of transperineal template biopsy (TPB) and multiparametric MRI (mpMRI).

Methods

A 36-question online survey was distributed to 545 members of the Urological Society of Australia & New Zealand (USANZ), including consultant urologists and trainees. This was an updated survey, based on a similar questionnaire distributed to USANZ members in 2012, addressing patterns of prostate biopsy practice in 4 domains: transrectal ultrasound-guided (TRUS) biopsy; TPB; mpMRI and peri-operative antibiotic and analgesia use. Survey results were collated and statistical analysis was performed using descriptive statistics and chi-squared test.

Results

155 participants completed the survey, with a response rate of 21.1%. 81.9% of respondents were consultant urologists and 66.5% worked in a metropolitan setting. 92.3% perform TRUS biopsy and 91.3% sample between 10-16 cores. 66.9% of respondents perform TPB, increased from 38.4% in 2012 (p<0.001). 59.4% perform mpMRI prior to initial biopsy, increased from 19.6% (p<0.001). 90.1% perform MRI prior to repeat biopsy after an initial negative biopsy. 97.2% use prophylactic oral antibiotics prior to TRUS biopsy, most commonly quinolones. 55.7% use parenteral antibiotics, compared to 69.4% previously (p=0.013). 27.7% routinely use carbapenem prophylaxis in settings of recent overseas travel or quinolone exposure, compared to 27.9% in 2012 (p=0.965). General anaesthetic/IV sedation is used for 60.6% of TRUS biopsies and 97.9% of TPB.

Conclusions

Our survey demonstrates a shift in practice of biopsy for the diagnosis of prostate cancer among urologists in Australia & New Zealand, when compared with results of our initial study in 2012. More urologists are performing TPB now, and there has been a corresponding increase in the use of pre-initial biopsy mpMRI despite no current guidelines recommending this practice yet. There has been a reduction in the use of parenteral antibiotics overall, prior to TRUS biopsy, however, rates of carbapenem use have remained stable, suggesting ongoing concerns regarding the risk of sepsis due to antibiotic resistance.

Funding

None