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Updated: Nov 2, 2025
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Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
Published on: June 6, 2025
676
Initial transperineal prostate biopsy experience at a high-volume center
Aaron Berkenwald1, Kristian D Stensland, Luke E Sebel
1Department of Urology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.
The Canadian Journal of Urology
|June 15, 2021
Summary
Transperineal prostate biopsy (TPBx) offers fewer infectious complications than transrectal prostate biopsy (TRUSBx). This study found TPBx well-tolerated with comparable discomfort and cancer detection rates, making it a safe alternative.
Area of Science:
- Urology
- Oncology
- Medical Procedures
Background:
- Transrectal prostate biopsy (TRUSBx) is associated with infectious complications.
- Transperineal prostate biopsy (TPBx) is a potential alternative with a lower risk of infection.
Purpose of the Study:
- To evaluate the initial experience and outcomes of transperineal prostate biopsy (TPBx) performed by a single, inexperienced physician.
- To compare TPBx with transrectal prostate biopsy (TRUSBx) and MRI/US fusion biopsy (MRIBx) in terms of patient comfort, procedural time, cancer detection, and complications.
Main Methods:
- A consecutive series of 303 patients undergoing prostate biopsy between June 2019 and March 2020 were analyzed.
- Data collected included patient discomfort, procedural duration, clinically significant cancer detection rates (csCDR), and 30-day complications for TPBx, TRUSBx, and MRIBx.
Main Results:
- TPBx showed no significant difference in discomfort compared to transrectal approaches.
- The transperineal group (n=92) had zero infectious complications, while the combined transrectal groups (n=211) had nine complications, including two sepsis events.
- Clinically significant cancer detection rates were comparable across TPBx (38%), TRUSBx (29.8%), and MRIBx (43.6%).
Conclusions:
- Transperineal prostate biopsy (TPBx) is well-tolerated and safe in an office setting.
- TPBx demonstrates a significantly lower rate of infectious complications compared to the standard transrectal technique.
- A rapid learning curve was observed for TPBx, with procedural times improving significantly after the initial cases.
