Prostate Cancer Detection and Complications of Transperineal Versus Transrectal Magnetic Resonance Imaging- fusion Guided Prostate Biopsies

OBJECTIVE To assess the rates of detection of clinically significant prostate cancer (csPCa) and complications associated with transperineal (TP) and transrectal (TR) biopsy approaches to magnetic resonance imaging (MRI)-fusion targeted biopsy. MATERIALS AND We retrospectively identified men who underwent TP or TR MRI-targeted biopsy with conMETHODS current systematic random biopsy from August 2020 to August 2021. Primary outcomes were detection rates of csPCa and 30-day complication rates between the 2 MRI-biopsy groups. Data were additionally stratified by prior biopsy status.RESULTS A total of 361 patients were included in the analysis. No demographic differences were observed. No significant differences were observed between TP and TR approaches on any of the outcomes of interest. TR MRI-targeted biopsies identified csPCa in 47.2% of patients, and TP MRI-targeted biopsies identified csPCa in 48.6% of patients (P = .78). No significant differences were observed in csPCa detection between the 2 approaches for patients on active surveillance (P = .59), patients with prior negative biopsy (P = .34), and patients who were biopsy naive (P = .19). Complication rates did not vary by approach (P = .45).CONCLUSION Neither the identification of csPCa by MRI-targeted biopsy nor rates of complications differed significantly based on a TR or TP approach. No differences were seen between MRI-targeted approaches based on prior biopsy or active surveillance status. UROLOGY 177: 109-114, 2023. & COPY; 2023 Elsevier Inc. All rights reserved.

Automated summary

This study assessed the rates of clinically relevant prostate cancer detection and complications associated with transperineal and transrectal biopsies guided by magnetic resonance imaging (MRI). The results showed no significant differences in the detection rates of clinically relevant prostate cancer and complication rates between the two biopsy approaches, regardless of prior biopsy status or active surveillance.