Outcomes of Systematic Transrectal Ultrasound-Guided Prostate Biopsy Performed by a Surgical Care Practitioner and Implications for Resource-Poor Countries

Introduction Prostate cancer remains the most prevalent cancer among men and continues to present a significant public health challenge globally. The disease's growing prevalence has heightened the demand for skilled professionals capable of obtaining histological samples for accurate diagnosis, as tissue biopsy remains the cornerstone for diagnosing prostate cancer. Surgical care practitioners have become integral to the surgical team, and their roles have expanded to include performing biopsies. This paper evaluates the outcomes of transrectal ultrasound-guided (TRUS) prostate biopsies conducted by a surgical care practitioner (SCP) and explores the implications for resource-poor countries. Methods We retrospectively collated data from 218 patients who underwent TRUS prostate systematic biopsy by a surgical care practitioner between 2020 and 2022. We evaluated the prostate-specific antigen (PSA) values, MRI Likert score where available, and histological data and determined diagnostic yield and complication rates. Results The mean age and PSA level of the men were 69.7 years and 61.2 ng/ml, respectively; an average of 12 cores were obtained per biopsy. The cancer detection rate was 128/218 (59%), with a mean Gleason grade of 2.8. From available MRI, Likert 3 was the most common finding, 45/103 (43.6%), and prostate cancer was found in 40%. The mean MRI Likert scores for a positive and negative biopsy were 4 and 3.3, respectively. We recorded three complications (1%), all Clavien-Dindo 1 to 2, with no mortality. Conclusion A well-trained, supported, and supervised surgical care practitioner can safely and effectively perform TRUS systematic prostate biopsies and may improve access to prostate cancer diagnosis in developing countries.