COMPARATIVE CHARACTERISTICS OF THE EFFECTIVENESS OF TRANSRECTAL AND TRANSPERINEAL PROSTATE BIOPSY

Prostate cancer is one of the most common oncological diseases in men, ranking first among the causes of mortality from malignant neoplasms in urological practice. Prostate biopsy remains the “gold standard” for morphological diagnosis of the disease. At the same time, the optimal access for tissue sampling - transrectal (TR) or transperineal (TP) - is still the subject of active debate.The aim of the study was to compare the effectiveness and diagnostic capabilities of transrectal and transperineal biopsies in patients with prostate cancer operated on by the same surgeon.Materials and methods. The study analyzed data from 124 patients who underwent TR (n=66) or TP (n=58) biopsy. Anthropometric parameters, MRI results, quantitative biopsy indicators, tumor distribution by prostate zones, accuracy of tumor localization, morphological category of tumors, and frequency of rectal mucosa contamination in biopsies were evaluated.Research results. TP biopsy was more effective in verifying tumors in the anterior and apical regions and allowed for more accurate targeting of the peripheral zone. There were fewer cases of biopsy contamination with rectal mucosa in the TP group. Morphological correspondence between biopsy and postoperative samples was higher in the TR group, but there was a significant increase in the proportion of G1 tumors after surgery in the TP group.Conclusions. TR biopsy remains an effective method for basal localization of suspicious foci and for outpatient primary screening. At the same time, TP biopsy has a clinical advantage in complex anatomical cases, with negative previous biopsies, and when planning focal therapy.