Comparison of transperineal and transrectal biopsy approaches for prostate cancer diagnosis

Introduction: Prostate cancer (PCa) is one of the most common cancers worldwide. Diagnosis is usually established by biopsy, performed either via the perineum (transperineal [TP]) or the rectal wall (transrectal [TR]). Material and methods:A PubMed search was conducted for English-language, high-impact journals published between 2019 and 2024.Results: A total of 17 articles met the inclusion criteria, covering PCa epidemiology, biopsy indications, and definitions of both approaches.Data addressed advantages, disadvantages, complication rates, costs, and comparative outcomes of TP and TR biopsies.Discussion: TP biopsies were consistently associated with lower sepsis risk compared to TR, as well as shorter hospital stays due to reduced infection and urinary retention.No significant differences were found between TP and TR approaches in the detection of clinically significant PCa, particularly in magnetic resonance imaging-targeted biopsies.Conclusion: TP biopsy appears to be a safer alternative to TR, with fewer complications, notably post-operative infections, urinary retention, and hospitalizations.While both methods achieve similar cancer detection rates, TP biopsy is preferable for anterior and apical lesions.Final selection should be tailored to patient-specific factors.