Transperineal Prostate biopsy Safer and More Effective than TRUS for Cancer Detection, finds study
The Local Anesthetic Transperineal Prostate biopsy is associated with lower rates of infection and sepsis compared with the Transrectal Ultrasound-Guided Prostate biopsy. It also shows a higher detection rate of overall prostate cancer and clinically significant cancer (Gleason Grade Group 2–5), suggesting improved safety and diagnostic accuracy.
A study was done to compare transrectal ultrasonography (TRUS) and local anaesthetic transperineal (LATP) biopsy. A systematic review of randomised controlled trials and prospective studies meeting eligibility criteria was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results: A total of 12 studies with 8497 patients were included. Local anaesthetic transperineal biopsy was performed in 3961 patients and transrectal ultrasonography biopsy in 4536. Patient characteristics were comparable in both groups. Infection (risk ratio [RR] 0.68, 95% confidence interval [CI] 0.56–0.84, P < 0.001) and sepsis rates were significantly lower in the local anaesthetic transperineal group (RR 0.16, 95% CI 0.08–0.33, P < 0.001) and urinary retention rates were comparable (RR 0.87, 95% CI 0.61–1.25, P = 0.46). Overall cancer detection rates were significantly higher in local anaesthetic transperineal biopsy (RR 1.07, 95% CI 1.03–1.10, P < 0.001) as were Gleason Grade Group 2–5 or clinically significant cancer detection rates (RR 1.12, 95% CI 1.06–1.18, P < 0.001). Gleason GG 1 detection rates were comparable (RR 0.92, 95% CI 0.82–1.04, P = 0.20).
The local anaesthetic transperineal biopsy is associated with lower rates of infection and sepsis compared to transrectal ultrasonography biopsy. The local anaesthetic transperineal biopsy also detects a higher overall incidence of prostate cancer and clinically significant prostate cancer (Gleason Grade Group 2–5).
Reference:
Calpin, G.G., Hehir, C.M., Alzayer, M., MacCurtain, B.M., Ryan, F.R., Inder, M.S., Moran, D.C., Galvin, D.J. and Breen, K.J. (2026), Transrectal vs transperineal prostate biopsy: a systematic review and meta-analysis. BJU Int. https://doi.org/10.1111/bju.70204
Keywords:
Transperineal, Prostate, biopsy, Safer, More, Effective, TRUS, Cancer, Detection, finds, study, Calpin, G.G., Hehir, C.M., Alzayer, M., MacCurtain, B.M., Ryan, F.R., Inder, M.S., Moran, D.C., Galvin, D.J. and Breen, K.J.
