TY - JOUR
T1 - Evaluating prostate biopsy practices across Indian institutions
T2 - A multi-center prospective observational study
AU - USI CRC Group1
AU - Prasad, Vishnu
AU - Agrawal, Shashank
AU - Pooleri, Ginil Kumar
AU - Reddy, Rajesh K.
AU - Singh, Mahendra
AU - Sabnis, Ravindra
AU - Ragavan, Narasimhan
AU - Kumar, Prem
AU - Tiwari, Rajesh
AU - Pawar, Prakash
AU - Trivedi, Sameer
AU - Kumar, Lalit
AU - Sood, Swapan
AU - Sharma, Aditya Prakash
AU - Nazir, Syed Sajjad
AU - Nayyar, Rishi
AU - Khanna, Ashish
AU - Radhakrishnan, Vijay
AU - Reddy, Vipin
AU - Dhayal, Ishwar Ram
AU - Sharma, Amit
AU - Priyadarshini, Shivam
AU - Mittal, Ankur
AU - Shah, Ashit
AU - Raghunath, S. K.
AU - Chawla, Arun
AU - Alhuwalia, Puneet
AU - Patwardhan, Sujata
AU - Agarwal, Vikas
AU - Vaddi, Chandra Mohan
AU - Soundarya, G.
AU - Kumar, Nitesh
AU - Choudhary, Lok Prakash
AU - Krishnamoorthy, Venkatesh
AU - Kumar, Vinod
AU - Aggarwal, Gaurav
AU - Sukhla, Abhishek
AU - Goyal, Suresh
AU - Sethia, Rajiv Kumar
AU - Sharma, Devendra K.
AU - Teja, Sepuri Bala Ravi
AU - Singh, Harprit
AU - Faridi, Mohammad Shazib
AU - Sallo, Stephen L.
AU - Neeli, Siddalingeshwar
AU - Kore, Prabhakar
AU - Pradhan, Aditya
AU - Batra, Vikram Shah
AU - Biswas, Manoj
N1 - Publisher Copyright:
© 2025 Indian Journal of Urology.
PY - 2026/1/1
Y1 - 2026/1/1
N2 - Background: Prostate cancer is the second most common malignancy globally amongst men. While prostate-specific antigen (PSA) screening aids in early detection, prostate biopsy remains the diagnostic gold standard. However, the biopsy practices vary widely across various Indian centers. This study aimed to evaluate the current biopsy techniques, indications, complications, and diagnostic yield across multiple institutions. Methods: A prospective, multi-center observational study was conducted from June 14, 2023, to June 14, 2024, under the Urological Society of India Collaborative Research Committee. Data from 2479 patients across 43 institutions were collected using a standardized template. Men aged ≥40 years undergoing initial or repeat biopsies were included. Variables included demographics, PSA levels, imaging, biopsy route and technique, antibiotic prophylaxis, pain scores, complications, and histopathology. Analysis was performed using SPSS v23. Results: Elevated PSA was the primary indication of biopsy in 95.2% of the patients (median: 19.8 ng/ml). The transrectal route was used in 91.8% of the patients whereas the transperineal was used in 6.4%. Multiparametric magnetic resonance imaging was performed in 45%, with targeted cores in 15.6% of the patients. PIRADS 5 lesions had a cancer detection rate (CDR) of 81.4%, while PIRADS 2 had CDR of 23.1%; no cancers were found in PIRADS 2 lesions in repeat biopsy settings. Adenocarcinoma was diagnosed in 61% of the patients. Transrectal biopsies had a higher CDR (61.3% vs. 47.2%; P < 0.05) but also higher infection rates (3.3% vs. 0%; P = 0.03). Overall complication rate was 11%, with hematuria >1 day being the most common (6.5%) complication. Conclusion: This large, multi-institutional study highlights significant variability in prostate biopsy practices in India and emphasizes the need for standardized training to improve the diagnostic outcomes and safety.
AB - Background: Prostate cancer is the second most common malignancy globally amongst men. While prostate-specific antigen (PSA) screening aids in early detection, prostate biopsy remains the diagnostic gold standard. However, the biopsy practices vary widely across various Indian centers. This study aimed to evaluate the current biopsy techniques, indications, complications, and diagnostic yield across multiple institutions. Methods: A prospective, multi-center observational study was conducted from June 14, 2023, to June 14, 2024, under the Urological Society of India Collaborative Research Committee. Data from 2479 patients across 43 institutions were collected using a standardized template. Men aged ≥40 years undergoing initial or repeat biopsies were included. Variables included demographics, PSA levels, imaging, biopsy route and technique, antibiotic prophylaxis, pain scores, complications, and histopathology. Analysis was performed using SPSS v23. Results: Elevated PSA was the primary indication of biopsy in 95.2% of the patients (median: 19.8 ng/ml). The transrectal route was used in 91.8% of the patients whereas the transperineal was used in 6.4%. Multiparametric magnetic resonance imaging was performed in 45%, with targeted cores in 15.6% of the patients. PIRADS 5 lesions had a cancer detection rate (CDR) of 81.4%, while PIRADS 2 had CDR of 23.1%; no cancers were found in PIRADS 2 lesions in repeat biopsy settings. Adenocarcinoma was diagnosed in 61% of the patients. Transrectal biopsies had a higher CDR (61.3% vs. 47.2%; P < 0.05) but also higher infection rates (3.3% vs. 0%; P = 0.03). Overall complication rate was 11%, with hematuria >1 day being the most common (6.5%) complication. Conclusion: This large, multi-institutional study highlights significant variability in prostate biopsy practices in India and emphasizes the need for standardized training to improve the diagnostic outcomes and safety.
UR - https://www.scopus.com/pages/publications/105026154558
UR - https://www.scopus.com/pages/publications/105026154558#tab=citedBy
U2 - 10.4103/iju.iju_212_25
DO - 10.4103/iju.iju_212_25
M3 - Article
C2 - 41562011
AN - SCOPUS:105026154558
SN - 0970-1591
VL - 42
SP - 51
EP - 66
JO - Indian Journal of Urology
JF - Indian Journal of Urology
IS - 1
ER -
SDG 3 Good Health and Well-being