Breaking Update: Here’s a clear explanation of the latest developments related to Breaking News:Transperineal vs Transrectal Prostate Biopsy– What Just Happened and why it matters right now.
A REAL-WORLD comparative study from a Moroccan tertiary centre has found that transperineal (TP) prostate biopsy offers similar cancer detection rates to the traditional transrectal (TR) approach, while reducing infectious complications and improving tissue sampling quality.
Prostate biopsy remains the gold standard for confirming prostate cancer in men with clinical suspicion. Although the TR route is widely used in routine practice, it is associated with a higher risk of infection and may inadequately sample anterior regions of the prostate. In contrast, the TP approach has been proposed as a safer alternative, but comparative real-world data remain limited in certain healthcare settings.
Real-World Comparison of Prostate Biopsy Techniques
In this retrospective analysis, 139 men undergoing systematic prostate biopsy were evaluated. Patients received either TR or TP biopsy, with analyses focusing exclusively on systematic cores. The two groups were broadly comparable in baseline clinical characteristics, aside from differences in digital rectal examination findings.
The study found no significant difference in the detection of clinically significant prostate cancer (csPCa) between the two techniques, with detection rates of 40.3% for TR and 38.9% for TP. However, TP biopsy produced significantly longer median core lengths, suggesting improved tissue sampling quality. Several factors were associated with higher csPCa detection, including elevated prostate-specific antigen (PSA), increased PSA density, suspicious digital rectal examination findings, and higher PI-RADS scores. Interestingly, anterior lesion location was linked to a lower likelihood of detecting clinically significant disease.
Complication profiles differed between the two approaches. Infectious complications were notably higher in the TR group (7.5%) compared with the TP group (1.4%), reinforcing concerns about infection risk with the transrectal route. Rates of acute urinary retention were slightly higher in the TP group (8.3% versus 6.0% for TR). Importantly, no severe complications (Clavien–Dindo grade III or higher) were reported in either group.
What These Findings Mean for Clinical Practice
Overall, the findings support the growing shift towards TP biopsy in routine clinical practice. By offering comparable diagnostic performance, improved core quality, and a lower risk of infection, TP biopsy represents a compelling alternative to the conventional transrectal approach, particularly in efforts to minimise procedure-related morbidity.
Reference
El Ghazzaly A et al. Transperineal versus transrectal systematic prostate biopsy in routine clinical practice: a real-world comparative study. Front Urol. 2026; 6:180696.
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