Transperineal Biopsy

Transperineal biopsies are performed routinely as an outpatient procedure under localized anesthesia, but may also be performed in the operating room under general anesthesia. General anesthesia is administered to make it easier for the patient to stay still during the procedure, and to ultimately provide more comfort. Unlike a transrectal biopsy, where tissues samples are gathered through the rectum, transperineal biopsies gather samples through the perineum. An ultrasound probe is inserted in the rectum to allow imaging of the prostate, while samples are taken from each side of the prostate through only two primary skin puncture sites. This enables the physician to collect a distribution of samples from throughout the prostate, including access to the anterior (front) and apical (top) regions of the prostate as necessary.

What are the advantages of a transperineal approach?

  • Reduced risk of infection
  • Reduced risk of procedure-related bleeding
  • Increased chance for detecting cancers, particularly in the anterior of the prostate
  • A viable option for patients with anxiety about having a prostate biopsy procedure while fully awake, and who would prefer to be under a greater level of sedation or  anesthesia during the biopsy

Who is a good candidate for transperineal biopsy?

  • Patients who are on “active surveillance” for a slow-growing prostate cancer and are expected to need repeated biopsies
  • Patients with high PSA scores whose previous standard transrectal biopsies did not detect cancer (which may be a false-negative)
  • Patients suspected to possibly have tumors in the anterior or apical areas of the prostate
  • Patients with anxiety who may benefit from a greater level of anesthesia and sedation during the prostate biopsy procedure