Utility of multiple core biopsies during transperineal template-guided mapping biopsy for patients with large prostates and PI-RADS 1–2 on multiparametric magnetic resonance imaging

Abstract Background We investigated the necessity of multiple core biopsies when performing transperineal template-guided mapping biopsy (TTMB) for patients with large prostates and no suspicious lesions on multiparametric magnetic resonance imaging (mpMRI). Materials and methods We retrospectively analyzed 304 patients on active surveillance (AS), 212 patients with previously negative transrectal ultrasound-guided biopsy (TRUS-Bx) and 67 biopsy naive patients who underwent TTMB between May 2017 and December 2020. The number of core biopsies and acute urinary retention (AUR) rate were analyzed in relation to the prostate volume (PV). Cancer detection rate according to the prostate volume and Prostate Imaging-Reporting and Data System (PI-RADS) scores were compared using Pearson chi-square test. Results AUR occurred more frequently in patients with PV over 39 cc (5.5% vs. 24.4%, p Conclusion Increasing the number of core biopsies of prostates measuring ≥ 39 cc with PI-RADS 1–2 on mpMRI does not significantly increase the detection rates of any prostate cancer or csPCA.