Safety and diagnostic yield of percutaneous ultrasound-guided penile mass biopsy

To evaluate the safety, tolerability, and efficacy of ultrasound-guided percutaneous biopsy of penile masses.

A retrospective review of an institutional biopsy database was used to identify ultrasound-guided percutaneous biopsies of the penis performed between September 2004 and April 2025. Relevant clinical history, pre-biopsy imaging, biopsy technique, sedation plan, complications, final pathology, peri-procedural pain scores, and administered medications were recorded. Safety, tolerability, and efficacy of ultrasound-guided percutaneous biopsy of the penis were assessed.

There were 15 patients who underwent 16 ultrasound-guided percutaneous penile mass biopsies. Procedures were performed as core-needle biopsies (CNB) using 18- or 20-gauge devices (n = 9), as fine needle aspiration (FNA) using 25-gauge needles (n = 5), or as a combination of 25-gauge FNA and 20-gauge CNB (n = 2). Most biopsies were performed using local anesthetic only (9/16, 56%), or local anesthetic in conjunction with moderate sedation (7/16, 44%). One patient received a dorsal penile nerve block in addition to moderate sedation. The procedures were well-tolerated, with only a single patient reporting periprocedural pain scores above 2. No major complications occurred. A single patient developed a small-to-moderate hematoma which was managed conservatively. Most cases yielded diagnostic tissue (14/16, 87.5%). In the two cases with nondiagnostic tissue, no malignancy was discovered on subsequent workup.

Ultrasound-guided percutaneous biopsy is a safe, well-tolerated, and efficacious procedure that should be considered a viable technique for sampling penile masses.