“TREXIT 2020”: why the time to abandon transrectal prostate biopsy starts now

A new ‘Open Access’ perspective paper by Grummet, J., Gorin, M.A., Popert, R. et al. as published in Springer Nature’s Prostate Cancer and Prostatic Diseases, is calling for the full, global eradication of the transrectal (TRUS) prostate biopsy to transperineal (TP) biopsy under local anaesthetic to be instigated in 2020.

The authors assert that “a well-planned global ‘TRexit’ with a phase-out period of TR biopsy led by centres experienced in TP biopsy, should be […] aiming for completion by the end of 2022.”

Current standard practice is for most men to be offered a TRUS biopsy. Yet, the procedure has a high risk of sepsis / serious infection and bleeding, as well as inaccurate identification of potential cancer cells. The alternative transperineal or template (TP) biopsy has, in the past, typically only been available to men at greater risk of infection from certain medical conditions, and had to be done under general anaesthetic because of the need for multiple biopsy punctures. Now the picture has changed.

An innovative new freehand technique allows a comprehensive, systematic TP biopsy to be carried out under local anaesthetic (LA) with 2 simple punctures – the LA TP biopsy – making for safer, more accurate biopsies.

The paper states: “The issue has been addressed with the introduction of the PrecisionPoint Transperineal Access System™ (Perineologic, Cumberland, MD, USA), which attaches to the ultrasound probe and maintains a common access cannula in line with the probe. This simple device has revolutionized freehand MRI-targeted and systematic LATP biopsy and its successful use has been described by groups in the United States and UK.”

It continues: “The major barriers to implementation of in-office TP prostate biopsy […] have therefore now been removed.”

The authors believe that LA TP biopsy should become standard of care.

As partners to Perineologic and the sole distributors of the PrecisionPoint Transperineal Access System outside of North America, BXTAccelyon is proud to be supporting this global TRexit initiative.