Skip to main content

Transperineal Prostate Biopsy

  • Chapter
Prostate Biopsy

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Transperineal prostate biopsy is receiving renewed scientific interest. Although neglected for several decades in favor of transrectal ultrasound biopsy, the transperineal procedure continues to have a minor, but defined and specific role in prostate cancer diagnosis. It is an effective procedure for detection and has a low incidence of infective complications. This chapter illustrates the technique and surgical approach for transperineal biopsy. Comparison of the two procedures is offered.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Peck S. Transperineal needle biopsy of the prostate. J Urol 1972;107(6):1025–1027.

    CAS  PubMed  Google Scholar 

  2. Webb JA, Shanmuganathan K, McLean A. Complications of ultrasound-guided transperineal prostate biopsy. A prospective study. Br J Urol 1993;72(5 Pt 2):775–777.

    Article  CAS  PubMed  Google Scholar 

  3. Hodge KK, McNeal JE, Terris MK, Stamey TA. Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol 1989;142(1):71–74.

    CAS  PubMed  Google Scholar 

  4. Emiliozzi P, Longhi S, Scarpone P, Pansadoro A, DePaula F, Pansadoro V. The value of a single biopsy with 12 transperineal cores for detecting prostate cancer in patients with elevated prostate specific antigen. J Urol 2001;166(3):845–850.

    Article  CAS  PubMed  Google Scholar 

  5. Shandera KC, Thibault G P, Deshon JE Jr. Variability in patient preparation for prostate biopsy among American urologists. Urology 1998;52(4):644–646.

    Article  CAS  PubMed  Google Scholar 

  6. Takenaka A, Hara R, Hyodo Y, et al. Transperineal extended biopsy improves the clinically significant prostate cancer detection rate: a comparative study of 6 and 12 biopsy cores. Int J Urol 2006;13(1):10–14.

    Article  PubMed  Google Scholar 

  7. Ishidoya S, Ogata Y, Inaba Y, et al. Screening of prostate cancer with PSA and transperineal six sextant biopsy. Nippon Hinyokika Gakkai Zasshi 1999;90(5):579–585.

    CAS  PubMed  Google Scholar 

  8. Yamamoto S, Ito T, Aizawa T, et al. Does transrectal ultrasound guided eight-core prostate biopsy improve cancer detection rates in patients with prostate-specific antigen levels of 4.1–10 ng/mL? Int J Urol 2004;11(6):386–391.

    Article  PubMed  Google Scholar 

  9. Kawakami S, Kihara K, Fujii Y, Masuda H, Kobayashi T, Kageyama Y. Transrectal ultrasound-guided transperineal 14-core systematic biopsy detects apicoanterior cancer foci of T1c prostate cancer. Int J Urol 2004;11(8):613–618.

    Article  PubMed  Google Scholar 

  10. Ficarra V, Novella G, Novara G, Galfano A, Pea M, Martignoni G, Artibani W. The potential impact of prostate volume in the planning of optimal number of cores in the systematic transperineal prostate biopsy. Eur Urol 2005;48(6):932–937.

    Article  PubMed  Google Scholar 

  11. Luciani LG, De Giorgi G, Valotto C, Zanin M, Bierti S, Zattoni F. Role of transperineal six-core prostate biopsy in patients with prostate-specific antigen level greater than 10 ng/mL and abnormal digital rectal examination findings. Urology 2006;67(3):555–558.

    Article  PubMed  Google Scholar 

  12. Vis AN, Boerma MO, Ciatto S, Hoedemaker RF, Schroder FH, van der Kwast TH. Detection of prostate cancer: a comparative study of the diagnostic efficacy of sextant transrectal versus sextant transperineal biopsy. Urology 2000;56(4):617–621.

    Article  CAS  PubMed  Google Scholar 

  13. Emiliozzi P, Corsetti A, Tassi B, Federico G, Martini M, Pansadoro V. Best approach for prostate cancer detection: a prospective study on transperineal versus transrectal six-core prostate biopsy. Urology 2003;61(5):961–966.

    Article  CAS  PubMed  Google Scholar 

  14. Watanabe M, Hayashi T, Tsushima T, Irie S, Kaneshige T, Kumon H. Extensive biopsy using a combined transperineal and transrectal approach to improve prostate cancer detection. Int J Urol 2005;12(11):959–963.

    Article  PubMed  Google Scholar 

  15. Cooner WH, Mosley BR, Rutherford CL Jr, et al. Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen. J Urol 1990;143(6):1146–1152.

    CAS  PubMed  Google Scholar 

  16. Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for prostatic carcinoma with prostate specific antigen. J Urol 1992;147:841–845.

    CAS  PubMed  Google Scholar 

  17. Catalona WJ, Smith DS, Ratliff TL, Basler JW. Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 199325;270(8):948–954.

    Google Scholar 

  18. Reissigl A, Pointner J, Horninger W, et al. Comparison of different prostate-specific antigen cutpoints for early detection of prostate cancer: results of a large screening study. Urology 1995;46(5):662–665.

    Article  CAS  PubMed  Google Scholar 

  19. Bangma CH, Rietbergen JB, Kranse R, Blijenberg BG, Petterson K, Schroder FH. The free-to-total prostate specific antigen ratio improves the specificity of prostate specific antigen in screening for prostate cancer in the general population. J Urol 1997;157(6):2191–2196.

    Article  CAS  PubMed  Google Scholar 

  20. Rietbergen JB, Hoedemaeker RF, Kruger AE, Kirkels WJ, Schroder FH. The changing pattern of prostate cancer at the time of diagnosis: characteristics of screen detected prostate cancer in a population based screening study. J Urol 1999;161(4):1192–1198.

    Article  CAS  PubMed  Google Scholar 

  21. Babaian RJ, Toi A, Kamoi K, et al. A comparative analysis of sextant and an extended 11-core multisite directed biopsy strategy. J Urol 2000;163(1):152–157.

    Article  CAS  PubMed  Google Scholar 

  22. Tanaka H, Shinkai M, Jo Y, Matsuki T. Transrectal ultrasound guided transperineal systematic prostate biopsy. Nippon Rinsho 1998;56(8):2067–2071.

    CAS  PubMed  Google Scholar 

  23. Bazinet M, Meshref AW, Trudel C, et al. Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology 1994;43(1):44–51.

    Article  CAS  PubMed  Google Scholar 

  24. Schmid HP, Ravery V, Billebaud T, et al. Early detection of prostate cancer in men with prostatism and intermediate prostate-specific antigen levels. Urology 1996;47(5):699–703.

    Article  CAS  PubMed  Google Scholar 

  25. Canto EI, Singh H, Shariat SF, et al. Effects of systematic 12-core biopsy on the performance of percent free prostate specific antigen for prostate cancer detection. J Urol 2004;172(3):900–904.

    Article  PubMed  Google Scholar 

  26. Maffezzini M, Gavazzi L, Calcagno T, Capponi G, Bandelloni R. Still a place for the classical systematic sextant technique? Cancer detection rates and complications in 1025 consecutive prostatic biopsies. Arch Ital Urol Androl 2005;77(2):106–108.

    PubMed  Google Scholar 

  27. Ito K, Ohi M, Yamamoto T, et al. The diagnostic accuracy of the age-adjusted and prostate volume-adjusted biopsy method in males with prostate specific antigen levels of 4.1–10.0 ng/mL. Cancer 2002;95(10):2112–2119.

    Article  CAS  PubMed  Google Scholar 

  28. Ravery V, Billebaud T, Toublanc M, et al. Diagnostic value of ten systematic TRUS-guided prostate biopsies. Eur Urol 1999;35(4):298–303.

    Article  CAS  PubMed  Google Scholar 

  29. Eskew LA, Bare RL, McCullough DL. Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J Urol 1997;157(1):199–202.

    Article  CAS  PubMed  Google Scholar 

  30. Presti JC z, Chang JJ, Bhargava V, Shinohara K. The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial. J Urol 2000;163(1):163–166.

    Article  PubMed  Google Scholar 

  31. Siu W, Dunn RL, Shah RB, Wei JT. Use of extended pattern technique for initial prostate biopsy. J Urol 2005;174(2):505–509.

    Article  PubMed  Google Scholar 

  32. Pelzer AE, Volgger H, Bektic J, et al. The effect of percentage free prostate-specific antigen (PSA) level on the prostate cancer detection rate in a screening population with low PSA levels. BJU Int 2005;96(7):995–998.

    Article  PubMed  Google Scholar 

  33. Jones JS, Patel A, Schoenfield L, Rabets JC, Zippe CD, Magi-Galluzzi C. Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J Urol 2006;175(2):485–488.

    Article  PubMed  Google Scholar 

  34. Yamamoto S, Kin U, Nakamura K, et al. Transperineal ultrasound-guided 12-core systematic biopsy of the prostate for patients with a prostate-specific antigen level of 2.5–20 ng/mL in Japan. Int J Clin Oncol 2005;10(2):117–121.

    Article  PubMed  Google Scholar 

  35. Eskicorapci SY, Baydar DE, Akbal C, et al. An extended 10-core transrectal ultrasonography guided prostate biopsy protocol improves the detection of prostate cancer. Eur Urol 2004;45(4):444–448.

    Article  PubMed  Google Scholar 

  36. Durkan GC, Sheikh N, Johnson P, Hildreth AJ, Greene DR. Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol. BJU Int 2002;89(1):33–39.

    Article  CAS  PubMed  Google Scholar 

  37. O’Connell MJ, Smith CS, Fitzpatrick PE, et al. Transrectal ultrasound-guided biopsy of the prostate gland: value of 12 versus 6 cores. Abdom Imaging 2004;29(1):132–136.

    Article  PubMed  Google Scholar 

  38. Emiliozzi P, Scarpone P, DePaula F, et al. The incidence of prostate cancer in men with prostate specific antigen greater than 4.0 ng/mL: a randomized study of 6 versus 12 core transperineal prostate biopsy. J Urol 2004;171(1):197–199.

    Article  PubMed  Google Scholar 

  39. Kabalin JN, McNeal JE, Price HM, Freiha FS, Stamey TA. Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology and morphometric observations. J Urol 1989;141:1091–1094.

    CAS  PubMed  Google Scholar 

  40. Steuber T, Karakiewicz PI, Augustin H, et al. Transition zone cancers undermine the predictive accuracy of Partin table stage predictions. J Urol 2005;173(3):737–7341.

    Article  CAS  PubMed  Google Scholar 

  41. Liu IJ, Macy M, Lai YH, Terris MK. Critical evaluation of the current indications for transition zone biopsies. Urology 2001;57(6):1117–1120.

    Article  CAS  PubMed  Google Scholar 

  42. Deliveliotis C, Varkarakis J, Albanis S, Argyropoulos V, Skolarikos A. Biopsies of the transitional zone of the prostate. Should it be done on a routine basis, when and why? Urol Int 2002;68(2):113–117.

    Article  CAS  PubMed  Google Scholar 

  43. Miyake H, Kurahashi T, Muramaki M, Yamanak K, Hara I. Significance of routine transition zone biopsies in Japanese men undergoing transrectal ultrasound-guided prostate biopsies. Int J Urol 2005;12(11):964–968.

    Article  PubMed  Google Scholar 

  44. Shannon BA, McNeal JE, Cohen RJ. Transition zone carcinoma of the prostate gland: a common indolent tumour type that occasionally manifests aggressive behaviour. Pathology 2003;35(6):467–471.

    Article  PubMed  Google Scholar 

  45. Obek C, Ozkan B, Tune B, Can G, Yalcin V, Solok V. Comparison of 3 different methods of anesthesia before transrectal prostate biopsy: a prospective randomized trial. J Urol 2004;172(2):502–505.

    Article  PubMed  Google Scholar 

  46. Aus G, Damber JE, Hugosson J. Prostate biopsy and anaesthesia: an overview. Scand J Urol Nephrol 2005;39(2):124–129.

    Article  PubMed  Google Scholar 

  47. Autorino R, De Sio M, Di Lorenzo G, et al. How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature. J Urol 2005;174(6):2091–2097.

    Article  PubMed  Google Scholar 

  48. Igel TC, Knight MK, Young PR, et al. Systematic transperineal ultrasound guided template biopsy of the prostate in patients at high risk. J Urol 2001;165(5):1575–1579.

    Article  CAS  PubMed  Google Scholar 

  49. Pinkstaff DM, Igel TC, Petrou SP, Broderick GA, Wehle MJ, Young PR. Systematic transperineal ultrasound-guided template biopsy of the prostate: three-year experience. Urology 2005;65(4):735–739.

    Article  PubMed  Google Scholar 

  50. Satoh T, Matsumoto K, Fujita T, et al. Cancer core distribution in patients diagnosed by extended transperineal prostate biopsy. Urology 2005;66(1):114–118.

    Article  PubMed  Google Scholar 

  51. Crawford ED, Wilson SS, Torkko KC, et al. Clinical staging of prostate cancer: a computer-simulated study of transperineal prostate biopsy. BJU Int 2005;96(7):999–1004.

    Article  PubMed  Google Scholar 

  52. Stewart CS, Leibovich BC, Weaver AL, Lieber MM. Prostate cancer diagnosis using a saturation needle biopsy technique after previous negative sextant biopsies. J Urol 2001;166(1):86–91.

    Article  CAS  PubMed  Google Scholar 

  53. Rabets JC, Jones JS, Patel A, Zippe CD. Prostate cancer detection with office based saturation biopsy in a repeat biopsy population. J Urol 2004;172(1):94–97.

    Article  PubMed  Google Scholar 

  54. Demura T, Hioka T, Furuno T, et al. Differences in tumor core distribution between palpable and nonpalpable prostate tumors in patients diagnosed using extensive transperineal ultrasound-guided template prostate biopsy. Cancer 2005;103(9):1826–1832.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Emiliozzi, P., Pansadoro, V. (2008). Transperineal Prostate Biopsy. In: Jones, J.S. (eds) Prostate Biopsy. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-078-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-078-6_14

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-790-7

  • Online ISBN: 978-1-60327-078-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics