Prostate Biopsy: The Transperineal Approach Is Better!
Fabio Zattoni1, Giacomo Novara2, Fabrizio Dal Moro2
1Urology Clinic, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy; Department of Medicine, University of Padua, Padua, Italy.
European Urology Focus
|March 4, 2025
Summary
Transperineal prostate biopsy improves cancer detection and reduces infection risks compared to transrectal biopsy. This method supports antibiotic stewardship, lowering antimicrobial resistance and preserving gut microbiome health.
Area of Science:
- Urology
- Oncology
- Infectious Disease
Background:
- Transrectal prostate biopsy is a common diagnostic tool.
- Concerns exist regarding infectious complications and antibiotic resistance associated with transrectal biopsy.
Purpose of the Study:
- To compare the efficacy and safety of transperineal prostate biopsy versus transrectal prostate biopsy.
- To evaluate the impact on cancer detection rates, infectious complications, and antibiotic use.
Main Methods:
- Systematic review and meta-analysis of relevant studies.
- Comparative analysis of cancer detection in specific prostate zones.
- Assessment of infectious complication rates, including sepsis.
- Evaluation of antibiotic prophylaxis usage and antimicrobial resistance implications.
Main Results:
- Transperineal biopsy demonstrates superior cancer detection in certain prostate regions.
- Lower incidence of severe infectious complications, such as sepsis, observed with transperineal approach.
- Reduced need for antibiotic prophylaxis in transperineal biopsy procedures.
- Alignment with antibiotic stewardship principles and decreased risk of antimicrobial resistance.
Conclusions:
- Transperineal prostate biopsy presents significant advantages over the transrectal route.
- It offers enhanced cancer detection, improved safety profile regarding infections, and supports antimicrobial stewardship.
- This approach is recommended for reducing antibiotic resistance and preserving gut microbiome integrity.
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