Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates.

Objectives: We conducted a systematic review to compare the diagnostic utility of ultrasound-guided transperineal (TP) and transrectal (TR) prostate biopsy methods for prostate cancer detection.

Methods: We searched PubMed, Embase, Web of Science, and Cochrane databases up to October 30, 2023, for relevant studies, screening the literature and assessing bias independently.

Results: Eleven trials were analyzed using relative risk and 95% confidence intervals, with no evidence of publication bias. Diagnostic rates showed no significant difference between TP and TR biopsies (mean difference [MD]: 1.03, 95% confidence interval [CI]: 0.91-1.14, = 0.56). Prostate volume analysis also showed no significant difference (MD: -0.07, 95% CI: -0.73 to 0.59, < 0.0001, combined effect size = 0.83). Similarly, PSA levels were comparable between TP and TR biopsies (MD: 0.93, 95% CI: -0.44 to 2.30, < 0.0001, combined effect size = 0.18).

Conclusion: Both biopsy methods exhibit similar diagnostic accuracy; however, TP has a lower risk of biopsy.