In-Office, Urologist-Administered Propofol Sedation for Prostate Biopsies: Outcomes From 205 Cases.
- 1Clinic for Urology Stadtspital Zürich Zurich Switzerland.
- 2Clinic for Anesthesiology Stadtspital Zürich Zurich Switzerland.
- 3Clinic for Gastro-Enterology Stadtspital Zürich Zurich Switzerland.
Abstract
Background
Propofol sedation (PS) administered by nonanesthesiologists has been demonstrated as safe across various medical disciplines, yet its in-office use in urology remains limited. Prostate biopsies are typically performed either under local anesthesia or anesthesiologists-administered anesthesia, including sedation and general anesthesia. Both approaches are associated with well-recognized limitations such as patient discomfort and substantial resource requirements, contributing to the slow transition from the transrectal to the transperineal approach for prostate biopsy. PS administered directly by urologists could potentially overcome these barriers.Methods
In this study, a standardized, urologically performed and supervised PS workflow for prostate biopsies was established and interdisciplinarily implemented. Consecutive patients undergoing MRI/ultrasound fusion-guided prostate biopsy were retrospectively analyzed. Procedures were initially performed transrectally and subsequently expanded to the transperineal approach. Outcomes include descriptive analysis of sedation- and biopsy-related complications and patient-reported outcome measures (PROMs), biopsy access route, and utilization of anesthesia and operating room resources.Results
A total of 205 consecutive biopsies were performed under PS. No propofol-associated complications occurred. Biopsy-related complications were rare and limited to urinary retention (< 1%) and febrile urinary tract infection (< 2%). PROMs demonstrated excellent tolerability and comfort with this sedation method, with strong preferences for PS in the event of repeat biopsies. Following PS implementation, the proportion of transperineal biopsies substantially increased from initially 34% to 74%, while the use of general anesthesia and operating room resources was reduced from up to 45% to 17%.Conclusion
In-office administration of PS by urologists is safe and associated with excellent patient acceptance. Through simpler workflows and reduced need of anesthesiology and operating room resources, PS facilitates the implementation of the transperineal approach for prostate biopsy.
Related
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- Safety and Recovery Profile of Propofol-Based Intravenous Sedation for Endoscopic Retrograde Cholangiopancreatography in Adults: A Prospective Single-Center Observational Study
- Propofol versus remifentanil sedation for elective gastroscopy: a randomized controlled trial
- Electrophysiology Team-Administered Conscious Sedation for Pulsed-Field Versus Radiofrequency Ablation in Atrial Fibrillation.
- Adjunctive Oliceridine During Propofol or Ciprofol Sedation for Same-Session Bidirectional Endoscopy in Older Adults: A Multicenter Randomized 2×2 Factorial Trial.
BibTeX
@article{umbehr2026inoffice,
title = {{In-Office, Urologist-Administered Propofol Sedation for Prostate Biopsies: Outcomes From 205 Cases.}},
author = {Martin H Umbehr and Cédric Poyet and Zrinka Raguz Nakic and Andreas Rist and Christoph Gubler and Michael Müntener},
journal = {Anesthesiology research and practice},
year = {2026},
month = oct,
doi = {10.1155/anrp/7866620},
url = {https://europepmc.org/article/MED/42923606},
note = {CC BY},
}
RIS
TY - JOUR
TI - In-Office, Urologist-Administered Propofol Sedation for Prostate Biopsies: Outcomes From 205 Cases.
AU - Martin H Umbehr
AU - Cédric Poyet
AU - Zrinka Raguz Nakic
AU - Andreas Rist
AU - Christoph Gubler
AU - Michael Müntener
PY - 2026
DA - 2026/10/21
JO - Anesthesiology research and practice
DO - 10.1155/anrp/7866620
UR - https://europepmc.org/article/MED/42923606
AB - Background Propofol sedation (PS) administered by nonanesthesiologists has been demonstrated as safe across various medical disciplines, yet its in-office use in urology remains limited. Prostate biopsies are typically performed either under local anesthesia or anesthesiologists-administered anesthesia, including sedation and general anesthesia. Both approaches are associated with well-recognized limitations such as patient discomfort and substantial resource requirements, contributing to the slow transition from the transrectal to the transperineal approach for prostate biopsy. PS administered directly by urologists could potentially overcome these barriers.Methods In this study, a standardized, urologically performed and supervised PS workflow for prostate biopsies was established and interdisciplinarily implemented. Consecutive patients undergoing MRI/ultrasound fusion-guided prostate biopsy were retrospectively analyzed. Procedures were initially performed transrectally and subsequently expanded to the transperineal approach. Outcomes include descriptive analysis of sedation- and biopsy-related complications and patient-reported outcome measures (PROMs), biopsy access route, and utilization of anesthesia and operating room resources.Results A total of 205 consecutive biopsies were performed under PS. No propofol-associated complications occurred. Biopsy-related complications were rare and limited to urinary retention (< 1%) and febrile urinary tract infection (< 2%). PROMs demonstrated excellent tolerability and comfort with this sedation method, with strong preferences for PS in the event of repeat biopsies. Following PS implementation, the proportion of transperineal biopsies substantially increased from initially 34% to 74%, while the use of general anesthesia and operating room resources was reduced from up to 45% to 17%.Conclusion In-office administration of PS by urologists is safe and associated with excellent patient acceptance. Through simpler workflows and reduced need of anesthesiology and operating room resources, PS facilitates the implementation of the transperineal approach for prostate biopsy.
SN - 1687-6962
SN - 1687-6970
ER -