Transrectal and Transperineal Prostate Biopsy under Local Anesthesia with Transrectal Ultrasound Guidance Comprehensive Review of Techniques and Complications

Abstract

Background: Prostate cancer is a leading cause of cancer-related morbidity and mortality in men. Accurate diagnosis through prostate biopsy is essential for early detection and management. Transrectal ultrasound (TRUS)-guided biopsy has been the standard approach, but the transperineal route under local anesthesia has gained popularity due to potentially lower infection rates and better access to certain prostate regions. Objective: To compare the outcomes of transperineal and transrectal prostate biopsy under local anesthesia with TRUS guidance, focusing on feasibility, cancer detection rates, procedural times, and complication rates. Methods: A comprehensive literature search was conducted in PubMed, MEDLINE, EMBASE, and Cochrane Library databases for studies published from January 2000 to December 2023. Studies comparing transperineal and transrectal prostate biopsy techniques were included. Data on cancer detection rates, procedural times, and complications were extracted and synthesized narratively. Conclusion: Transperineal prostate biopsy under local anesthesia with TRUS guidance appears to be a viable alternative to the traditional transrectal approach, offering advantages in terms of cancer detection and reduced complication rates. Further large-scale, comparative studies are needed to confirm these findings and refine the technique.