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Should Transperineal Prostate Biopsy Be the Standard of Care?

  • Prostate Cancer (S Prasad, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We reviewed the advantages and disadvantages of transperineal prostate biopsy (TP-bx) to evaluate its potential role as the standard of care for prostate biopsy.

Recent Findings

Studies have suggested no difference in prostate cancer (PCa) detection rate between TP-bx and transrectal biopsy (TR-bx) but have suggested potentially increased detection of anterior prostate tumors. Advances in anesthetic technique have obviated the need for sedation thus allowing TP-bx to become an office-based procedure, which in turn can decrease the overall cost of TP-bx. Furthermore, given the low rate of infectious complications after TP-bx, some have foregone peri-procedural antibiotics without a change in the rate of infectious complications.

Summary

Recent procedural advances have made TP-bx a tolerable, office-based procedure. Given the similar diagnostic performance and the benefits for the patient and community, TP-bx should become the standard of care for prostate biopsy for most patients. Future efforts should address the barriers for more universal adoption.

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Abbreviations

AUR:

Acute urinary retention

CI:

Confidence interval

CI-PCa:

Clinically insignificant prostate cancer

CS-PCa:

Clinically significant prostate cancer

mpMRI:

Multiparametric magnetic resonance imaging

OR:

Odds ratio

PCa:

Prostate cancer

QOL:

Quality of life

RCT:

Randomized controlled trial

RR:

Relative risk

TP-bx:

Transperineal prostate biopsy

TR-bx:

Transrectal prostate biopsy

TRUS:

Transrectal ultrasound

UTI:

Urinary tract infection

VAS:

Visual analogue scale

References

Papers of particular interest, published recently, have been highlighted as: •  Of importance •• Of major importance

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Duke University, Durham, NC, USA

    Rand N. Wilcox Vanden Berg & Deborah R. Kaye

  2. Department of Urology, University of Michigan, Ann Arbor, MI, USA

    Arvin K. George

  3. Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA

    Arvin K. George

  4. Duke-Margolis Center for Public Policy, Duke University, Durham, NC, USA

    Deborah R. Kaye

  5. Duke Clinical Research Institute, Durham, NC, USA

    Deborah R. Kaye

  6. Duke Cancer Institute, Duke Cancer Center/Clinic 5-1, 20 Duke Medicine Circle Durham, Durham, NC, 27710, USA

    Deborah R. Kaye

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Correspondence to Deborah R. Kaye.

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Dr. Wilcox Vanden Berg has nothing to disclose. Dr. George reports Philips Medical—Research agreement. Dr. Kaye reports personal fees from Janssen Pharmaceuticals, outside the submitted work.

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Wilcox Vanden Berg, R.N., George, A.K. & Kaye, D.R. Should Transperineal Prostate Biopsy Be the Standard of Care?. Curr Urol Rep 24, 135–142 (2023). https://doi.org/10.1007/s11934-022-01139-0

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