J. Miller MB BS; C. Perumalla FRACS; G. Heap MB BS, FRACS.
Complications of transrectal versus transperineal prostate biopsy
Article first published online: 1 MAR 2005
ANZ Journal of Surgery
Volume 75, Issue 1-2, pages 48–50, January 2005
How to Cite
Miller, J., Perumalla, C. and Heap, G. (2005), Complications of transrectal versus transperineal prostate biopsy. ANZ Journal of Surgery, 75: 48–50. doi: 10.1111/j.1445-2197.2005.03284.x
- Issue published online: 1 MAR 2005
- Article first published online: 1 MAR 2005
- Accepted for publication 30 May 2004.
- prostatic neoplasms
Background: There are two established techniques of prostate biopsy: the more widely used transrectal technique, and the transperineal technique. Although the transrectal technique is faster, it is reported to have an increased risk of septic complications, which may be life threatening. The present study compares complication rates of both techniques at Nambour General Hospital.
Methods: The present retrospective study was performed by reviewing all available medical charts of men who underwent prostate biopsy during the years 1996−2001. The following data were recorded in a database: date of birth; digital rectal examination findings; serum prostate specific antigen (PSA); biopsy technique; number of cores taken; number of positive cores; Gleason grade and score; complications. Results were tabulated and simple statistical analysis performed to compare both groups.
Results: A total of 197 biopsies was included in the study, with 81 transperineal biopsies in 75 men, and 116 transrectal biopsies in 103 men. There was no statistically significant difference in complication rates, including sepsis, between transrectal biopsy and transperineal biopsy. The rate of sepsis was 1.2% for the transperineal technique, and 0% for the transrectal technique (P = 0.411, Fisher exact test). Overall complication rates were 22.2% for transperineal technique and 19.8% for transrectal technique (P = 0.773, Fisher exact test).
Conclusion: Although the present study was limited by retrospective design and size it suggests that both techniques are equally safe. A review of medical literature supports a tranperineal approach to patients who will tolerate sepsis poorly, or who have a suspected inflammatory cause of their raised PSA.