Transrectal vs transperineal prostate biopsy: a systematic review and meta-analysis
Gavin G Calpin1,2, Cian M Hehir2, Mariyah Alzayer2
1Department of Urology, St. Vincent's University Hospital, Dublin, Ireland.
BJU International
|March 9, 2026
Summary
Local anesthetic transperineal (LATP) biopsy shows lower infection and sepsis rates than transrectal ultrasonography (TRUS) biopsy. LATP biopsy also improves prostate cancer detection, including clinically significant cancers.
Area of Science:
- Urology
- Oncology
- Medical Imaging
Background:
- Transrectal ultrasonography (TRUS) biopsy is a common method for prostate cancer diagnosis.
- Transperineal biopsy techniques offer potential advantages in reducing infection risks.
Purpose of the Study:
- To compare the efficacy and safety of local anesthetic transperineal (LATP) biopsy versus TRUS biopsy.
- To evaluate cancer detection rates and complication profiles of both biopsy methods.
Main Methods:
- Systematic review and meta-analysis of randomized control trials and prospective studies.
- Included 12 studies with 8497 patients comparing LATP and TRUS biopsy.
Main Results:
- LATP biopsy demonstrated significantly lower infection (RR 0.68) and sepsis (RR 0.16) rates.
- Overall cancer detection (RR 1.07) and clinically significant cancer (Gleason Grade Group 2-5) detection (RR 1.12) were higher with LATP biopsy.
- Urinary retention rates were comparable between LATP and TRUS biopsy groups.
Conclusions:
- LATP biopsy is a safer alternative to TRUS biopsy, with reduced infection and sepsis rates.
- LATP biopsy offers superior detection of prostate cancer, particularly clinically significant forms.
- The findings support LATP biopsy as a preferred method for prostate cancer diagnosis.
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