Comparison between Ultrasound Guided Transperineal and Transrectal Prostate Biopsy: A Prospective, Randomized, and...

Area of Science:

• Urology
• Oncology
• Surgical Procedures

Background:

• Prostate cancer (PCa) diagnosis relies on biopsy.
• Transperineal prostate biopsy (TPBx) and transrectal prostate biopsy (TRBx) are common methods.
• Evidence is needed to guide the choice between TPBx and TRBx.

Purpose of the Study:

• To compare the efficacy and safety of TPBx versus TRBx in detecting prostate cancer.
• To provide data for clinicians selecting the optimal biopsy approach.

Main Methods:

• A prospective study comparing TPBx (n=173) and TRBx (n=166) in 339 patients with suspected PCa.
• Data collected included cancer detection rate (CDR), complication rates, pain scores (VAS), procedure time, and need for repeat biopsy or anesthesia.

Main Results:

• TPBx and TRBx demonstrated equivalent CDR (35.3% vs. 31.9%) and minor complication rates (44.9% vs. 41.0%).
• TPBx had a significantly lower major complication rate (0.6% vs. 4.3%).
• TPBx procedures were longer (17.5 vs. 14.7 min), more painful (VAS 4.0 vs. 2.0), and had higher rates of repeat biopsy (3.2% vs. 1.1%) and additional anesthesia (15.0% vs. 1.2%).

Conclusions:

• Both TPBx and TRBx are effective for prostate cancer detection.
• TPBx offers a lower major complication rate but involves increased complexity, pain, and procedural time.
• The choice between TPBx and TRBx may depend on patient factors and clinical setting.