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Transperineal prostate biopsy in the diagnosis of prostate cancer

Publication at Third Faculty of Medicine |
2021

Abstract

Despite advances in imaging methods and the use of novel biomarkers, prostate biopsy still plays a vital part in prostate cancer diagnostics. Along with the widespread use of MRI/TRUS fusion guided biopsies we are recently witnessing a resurgence of transperineal approach in prostate biopsy.

Transperineal prostate biopsy (TPBxP) offers to avoid infectious complications by omitting the transrectal approach. Furthermore, TPBxP offers to improve the detection rate in the, sometimes undersampled, anterior part of the gland in patients after previous negative transrectal biopsies or with anterior prostate lesions visible on MRI.

As TPBxP is not yet widely used in clinical practice, in this text we aim to offer a review of literature concerning TPBxP available in the PubMed database. According to the available data, TPBxP is easy to perform under general or local anaesthesia and is well tolerated by patients.

Detection rate of prostate cancer is similar to that of the transrectal approach, except in the anterior parts of the prostate where TPBxP detects more cancer. TPBxP also seems to have less infectious complications and cases of rectal bleeding after biopsy.

The incidence of other prostate biopsy complications is similar between transrectal and transperineal approach.