A retrospective comparison of trans-rectal and trans-perineal prostate biopsies: experience of a single surgeon.

Abstract

Transrectal ultrasound-guided biopsy (TRUS) is the gold standard for undertaking prostate biopsy however it has been associated with higher rates of post-biopsy sepsis than transperineal biopsy (TP). To compare complication rates between transrectal prostate biopsy and transperineal biopsy for a single surgeon. Data were collected for all prostate biopsies undertaken by a single experienced urologist through his private rooms between February 2012 and March 2018. In total, 693 cases were included (560 individual men) in the final analysis (transrectal = 274, transperineal = 417). All patients were followed up two weeks post-biopsy and complications were recorded (sepsis, urinary tract infection, bleeding, acute urinary retention). Complications occurred in 37 cases (transrectal = 3, transperineal = 34). Sepsis occurred in one case following transrectal biopsy (0.36%) and two cases following transperineal biopsy (0.48%). Urinary tract infection occurred in two cases following transrectal biopsy (0.72%) and two cases following transperineal (0.48%). Bleeding occurred in one case following transperineal biopsy (0.24%). The most common complication was acute urinary retention, which occurred in 28 cases following transperineal biopsy (6.71%). Data from this study comparable complication rates for both transperineal and transrectal prostate biopsies in a single surgeon study.