Sylvester Researchers Bring New Prostate Biopsy Program to Florida

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Patients at the Sylvester Comprehensive Cancer Center who require a prostate biopsy now have the option to receive a transperineal biopsy.

Dr. Punnen and Dr. Nahar
From left, Dr. Sanoj Punnen and Dr. Bruno Nahar look at a transperineal biopsy ultrasound.

Traditionally, prostate biopsies to rule out prostate cancer are done through a needle, taking a total of 20 to 30 minutes to complete. The older transrectal method involves inserting a needle through the rectum, resulting in a more invasive procedure that can result in complications such as urinary sepsis, bacteria resistance to antibiotics and excess bleeding. The newer transperineal method takes an additional 5 to 10 minutes but offers significant benefits for patients in a more comfortable setting and, more importantly, a more accurate sampling of the prostate.

The program is one of the first in Florida to utilize this method for prostate cancer biopsy. Bruno Nahar, M.D., assistant professor of urologic oncology, and Sanoj Punnen, M.D., associate professor of urologic oncology, created the protocols needed to implement the procedure after completing training on this innovative method.

“This is where the transperineal method comes into play,” Dr. Nahar said. “The procedure goes through the skin between the area of the rectum and scrotum, giving the patient an almost zero risk of infection while increasing cancer detection rates. We also use MRI to guide the biopsy, which works similarly to a GPS and allows us to pinpoint specific areas we weren’t able to reach.”

“This approach provides the same if not better cancer detection compared to the transrectal approach, but with nearly zero risk of a complicated infection,” added Dr. Punnen. “As the risk of antibiotic-resistant infections continues to rise in the U.S. post-biopsy, we will see more and more providers switch over to this platform.”

Patients who require a prostate biopsy will still have the option of choosing between the transrectal or transperineal method, or having the procedure done with local anesthesia at the office or in the operating room.

“We hope that this newer method, however, catches on with more clinics in the U.S. as it has in Europe,” Dr. Nahar said. “Though there is a bit of a learning curve in the new procedure, it is more cost-effective, with a greater chance of avoiding infections, and has an overall benefit for the patient.”

For now, Drs. Nahar and Punnen have set the example in Florida while being positive the trend for transperineal biopsies will ultimately translate to better patient care.

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