A questionnaire survey of patient preparation and techniques for prostate biopsy among urologists in the Kyushu and Okinawa regions of Japan.

BACKGROUND: We surveyed urologists in the Kyushu and Okinawa regions of Japan regarding their standard approach to patient preparation and their prostate biopsy technique.

METHODS: A total of 155 survey questionnaires were prepared and mailed to community and academic urologists in the Kyushu and Okinawa regions. Incidences were derived from the total numbers of responses, by item, divided by the total number of responses per practice type.

RESULTS: There were 27 responses from clinics (17.4%), 115 from general hospitals (74.2%), and 13 from university hospitals or cancer centers (8.4%). Most urologists performed biopsy in patients with prostate-specific antigen (PSA) levels greater than 4 ng/ml when digital rectal examination (DRE) and/or transrectal ultrasound (TRUS) results were normal. Of the urologists, 83% reported performing the procedure with hospitalization; 51% of urologists do not advocate enema use, 69% performed the procedure under spinal anesthesia or a sacral block, 53% reported the combined administration of antibiotics orally and intramuscularly or intravenously, 70% used only the transrectal route for prostate biopsy, and 86.5% performed six or more biopsy cores at the initial prostate biopsy session.

CONCLUSION: This survey shows substantial variation in the prostate biopsy protocols among urologists in the Kyushu and Okinawa regions in Japan, and suggests that national, evidence-based, guidelines are required, particularly as to antibiotic prophylaxis and the number of biopsy cores.