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Dr. Mian on future studies of different approaches to prostate biopsy

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"We're going to look at whether that difference in the protocol has clinically meaningful implications, such as are patients who receive antibiotic prophylaxis at higher risk of developing resistance in the future?" says Badar M. Mian, MD.

In this video, Badar M. Mian, MD, discusses future work based on the study, “Complications Following Transrectal and Transperineal Prostate Biopsy: Results of the ProBE-PC Randomized Clinical Trial,” for which he served as the lead author. Mian is a professor of surgery in the division of urology at Albany Medical College in Albany, New York.

Video Transcript:

What future work is planned for this study?

The topic of transrectal vs transperineal biopsy is still an interesting one. We have other things to look at. One of those is the difference of cancer detection rates amongst a procedure, whether we find more cancers or certain types of cancers if you perform one procedure vs the other. We have completed that trial also. We had to increase the sample size to over 800 patients to answer the second question, whether one biopsy technique is going to be superior than the other biopsy technique in terms of finding clinically significant prostate cancer. That study is completed. That manuscript is being written, so that work should be presented hopefully at this upcoming AUA meeting in San Antonio. That'll be interesting additional information that be useful to clinicians.

What is the overall take-home message for urologists?

One of the things is just about the evidence. Sometimes what we believe may not turn out to be the case when we perform rigorous studies. In this situation, a large number of clinician investigators felt that this shift will show a difference, that the transperineal biopsy should have resulted in fewer complications. Based on that existing evidence, that seemed to be the case and that's why many of us, including ourselves, had not completely switched but had incorporated transperineal biopsy into our practice. That goes to how the evidence is viewed and consumed by us and our colleagues. Having level 1 evidence really is important. Even things that seem so intuitive may or may not turn out to be once we look at those closely through randomized clinical trials. We are looking at the additional aspect of the difference in the techniques. As I mentioned before, we do use antibiotic prophylaxis for 1 day. Patients receive a single dose or 1 day's worth of antibiotics for the transrectal prostate biopsy. We did not use that for transperineal. So, we're going to look at whether that difference in the protocol has clinically meaningful implications, such as are patients who receive antibiotic prophylaxis at higher risk of developing resistance in the future? That is one more ongoing study from this trial that should be presentable, hopefully this year.

This transcription has been edited for clarity.

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