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Updated: Feb 21, 2026
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Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
Published on: June 6, 2025
1.8K
The eternal enigma in prostatic biopsy access route
Andrea Fabiani1, Emanuele Principi, Alessandra Filosa
1Surgery Department, Section of Urology, ASUR Marche Area Vasta 3 Macerata Hospital. andreadoc1@libero.it.
Summary
Transrectal (TR) prostate biopsy detected more cancers than transperineal (TP) biopsy in initial screenings. TR biopsy also showed better accuracy for specific patient groups, with similar complication rates between the two methods.
Area of Science:
- Urology
- Oncology
- Medical Imaging
Background:
- Prostate cancer diagnosis relies on biopsies, but the superiority of fusion-guided techniques over traditional ultrasound-guided biopsies remains debated.
- Transperineal (TP) and transrectal (TR) prostate biopsy approaches are widely used, yet their comparative efficacy and complication rates require further investigation.
- Existing studies present conflicting results, highlighting the need for real-world data comparing TP and TR biopsy effectiveness in initial prostate cancer detection.
Discussion:
- This prospective study evaluated the cancer detection rates of TR versus TP prostate biopsy in 352 patients.
- The TR approach utilized a sagittal technique, while the TP approach used a single perineal median access.
- Statistical analysis revealed a significantly higher cancer detection rate for TR biopsy compared to TP biopsy.
Key Insights:
- Transrectal biopsy demonstrated a 48.48% cancer detection rate, significantly higher than the 33.69% rate for transperineal biopsy (p=0.0047).
- Transrectal biopsy showed superior diagnostic accuracy in patients with PSA < 4 ng/ml, intermediate prostate volume (30-50 ml), and normal digital rectal examination.
- Complication rates were similar between the TR and TP biopsy groups.
Outlook:
- Further research is needed to determine if the TR approach offers better prostate cancer staging compared to the TP approach as a primary procedure.
- The findings suggest that TR biopsy may be a more effective initial diagnostic tool, particularly in specific patient subgroups.
- Optimizing biopsy techniques and accessibility remains crucial for improving prostate cancer diagnosis and management.
