Transperineal prostate biopsy guided by which ultrasound transducer: transrectal or transperineal: a retrospective study.

Background: Prostate biopsies are primarily conducted using either the transrectal or transperineal approach, with the ultrasound probe positioned in the rectum to obtain a clear view of the prostate. Reports on the utilization of transperineal prostate biopsies with the ultrasound probe placed on the perineal skin are limited.

Methods: A retrospective investigation was conducted on 119 patients who underwent transperineal ultrasound guided transperineal prostate biopsy (TP-TPPB). Additionally, 85 patients who underwent transrectal ultrasound guided transperineal prostate biopsy (TR-TPPB) were included as controls. The prostate cancer detection rates (PCDRs) and postoperative complication rates were compared between the two groups, and their application values were also evaluated.

Results: The overall PCDRs were 35.3% (42/119) in the TP-TPPB and 32.9% (28/85) in the TR-TPPB group (2 = 0.122,  = 0.727). When categorized by PSA level, there was no significant difference between the two groups in PCDRs in any category ( > 0.05). However, the single-needle PCDRs in some regions (L4, L5, R2, and apex) showed significant differences ( < 0.05). There was no difference in postoperative complication rates between the groups.

Conclusion: The PCDRs and the postoperative complication rates of TP-TPPB and TR-TPPB are similar. However, TP-TPPB requires simpler equipment and does not require intestinal preparation, which is especially useful for patients with rectal contraindications, such as those with severe hemorrhoids and rectal/anal diseases.