Reduced Rate of Complications With Transperineal Prostate Biopsy: Real-world Data From a National Cohort Derived From the Danish Prostate Cancer Registry

Background and objective: Prostate biopsy remains the diagnostic gold standard for prostate cancer despite advances in magnetic resonance imaging (MRI) and prostate-specific membrane-antigen positron emission tomography imaging. Transrectal (TR) biopsy is associated with a substantial risk of infection and hospitalization. With biopsy-related infections rising globally, improvements in biopsy technique are urgently needed. The aim of this study was to assess the impact of the transition to transperineal (TP) biopsy on hospitalization rates. Methods: We analyzed data from the Danish Prostate Cancer Registry on all-cause hospitalizations within 7 d after biopsy according to procedure type, using logistic regression with adjustments for age, comorbidity, region of residence, prostate-specific antigen, International Society of Urological Pathologists grade, risk group, MRI use, and stratification on year of diagnosis. Key findings and limitations: We identified 19 456 men diagnosed with prostate cancer between 2020 and 2024. During the study period, TP biopsy use increased from