For men choosing to screen for prostate cancer (PCa), biopsy remains critical for diagnosis. While transrectal ultrasound-guided (TRUS) biopsy has been the standard of care for many years, recent concerns regarding post-procedural infection have led to increased interest in prostatic sampling via the transperineal (TP) approach. However, TRUS biopsy features important patient-related and physician/practice-related advantages compared to the TP method, and there are several useful strategies to effectively mitigate infectious concerns. The benefits associated with TRUS biopsy, particularly patient comfort and efficient clinical workflow, are further accentuated by several key shortcomings associated with switching to the TP approach. Herein, we present an argument in favor of maintaining TRUS biopsy as standard practice, discussing significant topics including infectious complications, practice workflow and cost, cancer detection rates, and patient experience.
Urology. 2022 Jan 14 [Epub ahead of print]
Srinath Kotamarti, Arvin George, Alex Zhu, Thomas J Polascik
Division of Urology, Duke Cancer Institute, Durham, NC. Electronic address: ., Department of Urology, University of Michigan Hospital, Ann Arbor, MI., Division of Urology, Duke Cancer Institute, Durham, NC.