Complications and specimen quality in transrectal ultrasound guided prostate biopsy: Comparison of 16G and 18G needles

Abstract

Objectives: To evaluate specimen quality, pathological results, complications and pain in transrectal ultrasound (TRUS) guided prostate biopsy using 16 gauge (G) or 18G biopsy needles

Design: Retrospective study

Setting: Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey

Subjects: Retrospective analysis of 243 TRUS guided prostate biopsies between March 2011 and April 2016

Interventions: Group 1 (n=121) underwent TRUS guided prostate biopsy using a 16 G needle and Group 2 (n=122) underwent TRUS guided prostate biopsy with an 18 G-needle.

Main outcome measures: We compared two biopsy needle sizes (16G vs 18G) in relation to sample quality, prostate cancer detection rate, pain, bleeding and infection rates in 243 patients. Core fragmentation and short specimen length (<10mm) rate were the sample quality criteria. Pain was evaluated using visual analog scale (VAS).

Results: There were no statistically significant differences in mean patient ages, prostate-specific antigen values and prostate volumes between groups 1 and 2. Sixteen gauge needles caused significantly less fragmentation of the biopsy cores when compared to 18G needles (p=0.00), but no statistically significant difference between two groups was recorded for pathological results (p=0.72) and shorter specimen length (p=0.567). Haematuria, rectal bleeding and infection were similar in both groups. Mean VAS score of group 1 was significantly greater than that of group 2 (3.19 vs 2.66;p=0.027).

Conclusion: Though thicker needles provided better sampling quality, the cancer detection rate was not altered by the needle size. Also, even though complication rates were similar for different needle sizes, the 18G needles were better tolerated.