At the IURES 2025 Congress, researchers presented new findings demonstrating the feasibility and diagnostic value of adding seminal vesicle sampling to transperineal prostate biopsy (TP-Bx) procedures. The study focused on patients with suspected seminal vesicle invasion identified through multiparametric MRI and aimed to determine whether this additional sampling could improve cancer detection and staging accuracy.
Study Design and Methodology
Between October 2023 and February 2025, forty-two patients who underwent transperineal prostate biopsy were evaluated. The inclusion criterion was the presence of suspected seminal vesicle invasion on MRI. In each case, standard systematic prostate sampling was accompanied by the collection of a single targeted biopsy core from both seminal vesicles. All procedures were performed under local anaesthesia in the lithotomy position.
Findings and PI-RADS Analysis
Among the nineteen patients whose seminal vesicle samples were suitable for evaluation, nearly half (47.4%) were found to have malignant pathology, while the remainder were benign. Clinically significant prostate cancer was identified in 31.6 per cent of the patients, and clinically insignificant disease in 15.8 per cent. The mean age of participants was 64 years, with an average PSA level of 8.2 ng/mL and an average prostate volume of 59 mL.
Further analysis examined the relationship between malignancy and PI-RADS scores. Of the evaluable cases, 36.8 per cent were classified as PI-RADS 3, 42.1 per cent as PI-RADS 4, and 21.1 per cent as PI-RADS 5. The malignancy rate increased in parallel with PI-RADS score, supporting the predictive value of MRI-based grading. Positive seminal vesicle biopsy results were observed in 22 per cent of PI-RADS 3 cases, 44 per cent of PI-RADS 4 cases, and 33 per cent of PI-RADS 5 cases.
Clinical Implications
The researchers emphasised that the transperineal approach offers direct anatomical access to the seminal vesicles, making the technique technically feasible and safe. Their findings suggest that including seminal vesicle sampling in transperineal prostate biopsies could provide valuable information for staging and treatment planning in patients with suspected seminal vesicle invasion.
Reference
Akdağcık Z et al. Seminal Vesicle Sampling in Transperineal Prostate Biopsy: Feasible or Not? IURES 2025; Mugla, Türkiye.
