Transperineal Prostate Biopsy

What is a Transperineal Prostate Biopsy?

A transperineal prostate biopsy is a procedure used to diagnose prostate cancer. Small samples of prostate tissue are taken using a needle passed through the skin between the scrotum and anus (the perineum). This approach is the preferred method of prostate biopsy because it has a much lower risk of infection than the traditional transrectal approach and is also more accurate.

Who may benefit?

A biopsy may be recommended if you have:

  • An elevated or rising PSA which has been repeated and remains elevated

  • An abnormal prostate examination (firm, nodular or irregular feeling prostate)

  • A suspicious area seen on MRI

  • Ongoing concern for prostate cancer despite previous negative biopsies

  • Men who are undergoing Active Surveillance for low-risk prostate cancer may need a repeat biopsy as part of the surveillance protocol

What happens during surgery?

The procedure is performed under a quick general anaesthetic as a day procedure. An ultrasound probe is placed in the rectum to guide the biopsy needle. If you have had a prostate MRI, the MRI images will often be fused with the live ultrasound (MRI-ultrasound fusion biopsy), allowing targeted sampling of suspicious areas while also taking systematic biopsies from throughout the prostate.

A cystoscopy is often performed at the same time as the biopsies to visualise the inner part of the prostate as well as the urethra and bladder.

Recovery

Most patients return home the same day. Mild blood in the urine, semen or stool is common for up to 6 weeks after the procedure. Most men can return to normal activities within 24 – 48 hours.

Benefits

  • Most accurate method for diagnosing prostate cancer

  • Lower risk of serious infection than transrectal biopsy

  • Day procedure with a quick recovery

  • Very quick procedure

Risks

  • Temporary blood in the urine, semen or stools

  • Urinary discomfort or difficulty passing urine which occasionally requires a temporary catheter until swelling of the prostate subsides

  • Bruising of the perineum

  • Rarely, infection

More Information

Dr Simeon Ngweso consults at St John of God Berwick Consulting Suites. Whether you’re seeking a second opinion or specialist care, you’re in experienced hands.

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