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Updated: Jan 28, 2026

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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Transperineal versus Transrectal Prostate Biopsy: Comparative Analysis of Cancer Detection and Complication Rates.

Mihai-Alexandru Radu1, Andrei Pănuș1, Andrei Drocaș1

  • 1Department of Urology, University of Medicine and Pharmacy of Craiova, Romania.

Current Health Sciences Journal
|January 26, 2026
PubMed
Summary

Transperineal (TP) prostate biopsy offers higher overall cancer detection and fewer complications than transrectal (TR) biopsy. This approach maintains diagnostic accuracy for clinically significant prostate cancer (csPCa) without age bias.

Keywords:
Prostatebiopsycancercomplicationstransperinealtransrectal

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Area of Science:

  • Urology
  • Oncology
  • Medical Diagnostics

Background:

  • Prostate cancer is a leading male malignancy.
  • Ultrasound-guided biopsy is the gold standard for diagnosis.
  • Transrectal (TR) biopsy has risks of infection and bleeding.
  • Transperineal (TP) biopsy aims to reduce these risks.

Purpose of the Study:

  • Compare cancer detection rates between TP and TR prostate biopsies.
  • Evaluate histopathological patterns and complication rates.
  • Assess the diagnostic accuracy and safety of each biopsy route.

Main Methods:

  • Retrospective analysis of 310 patients (TP: 178, TR: 132).
  • Defined clinically significant prostate cancer (csPCa) as Gleason score ≥7 or ISUP grade ≥2.
  • Compared detection rates, ISUP distribution, and complications using Chi-square tests.

Main Results:

  • TP biopsy had a higher overall cancer detection rate (60.67% vs 49.24%).
  • Complications were significantly lower with TP biopsy (6.7% vs 15.2%).
  • Infections and rectal bleeding occurred only in the TR group.

Conclusions:

  • TP biopsy is superior in overall cancer detection and safety compared to TR biopsy.
  • TP biopsy achieves comparable detection of csPCa with fewer complications.
  • The procedural route, not patient factors, explains the lower complication rate of TP biopsy.