Intraperitoneal Bleeding After Ultrasound-Guided Transperineal Prostate Biopsy

Transperineal prostate biopsy is becoming a popular approach in the diagnosis of prostate cancer. Urethral bleeding and urinary retention are the most common complications. We report a case of intraperitoneal bleeding after transperineal prostate biopsy in a patient with history of focal therapy for prostate cancer. The patient presented with dizziness, abdominal pain, and tenderness a few hours after the procedure. A computed tomography (CT) scan showed intraperitoneal bleeding. He was managed conservatively without needing any interventions or blood transfusion. Intraperitoneal bleeding is a possible, rare, and unexpected complication after transperineal biopsy especially in smaller prostates with prior procedures and scarring.