Objective:

To describe a new approach to perform ultrasound-MRI-guided prostate biopsies in patients without access to the rectum.

Methods:

Patients with elevated prostate-specific antigen (PSA) levels and absent rectum approach to perform a traditional transrectal prostate biopsy (TPB) pose a challenge in clinical practice. In this study, we describe a useful new device to guide biopsy in patients with target lesions in a multiparametric-MRI (mpMRI) and no availability of TPB.

Results:

We present two different cases of patients with PSA elevation and mpMRI lesion and no possibility of TPB. They underwent a modified single-port transperineal biopsy technique using MRI coregistered images and eTRAX device-assisted, to accurately guide the biopsy to the target lesion. The target biopsy diagnosed significant prostate cancer in both cases and no complications occurred after the procedure.

Conclusion:

In patients with no rectum access, ultrasound MRI coregistration biopsies assisted by eTRAX device seem to be an alternative minimally invasive approach since it is effective, reproducible, and safe.

No competing financial interests exist.

Runtime of video: 3 mins 57 secs

The initial study was presented at the 2021 American Congress of Urology in a virtual format. The abstract is available at https://www.auajournals.org/doi/pdf/10.1097/JU.0000000000002111.05.

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Total Transperineal Biopsy with Ultrasound-MRI Coregistration for Patients with No Rectum Access