Ultrasound-Guided Transperineal Prostate Biopsy

Prostate cancer is one of the most commonly diagnosed malignancies in American men (second only to skin cancer). For this reason, many experts recommend an annual prostate cancer screening beginning at age 50 for men at average risk. The screening process may involve a blood test, a prostate-specific antigen (PSA) test and/or a digital rectal exam (DRE). If a man's PSA level is elevated or his DRE returns an abnormal result, the next step is usually a biopsy, which is the only way to confirm a diagnosis of prostate cancer.

The disadvantages of the traditional transrectal approach

Most prostate biopsies are performed transrectally. Although this approach can be effective and has been used for many years, it has two significant downsides. First, because the biopsy needle is passed through the potentially contaminated rectum, there is a heightened risk of sepsis, a life-threatening infection. Second, some areas of the prostate, including the anterior prostate, tend to be undersampled in a transrectal ultrasound-guided prostate biopsy, which increases the risk of missing the cancer and producing a false negative result.

The advantages of the new transperineal approach

A transperineal ultrasound-guided prostate biopsy is a safer and more accurate alternative to a transrectal ultrasound-guided prostate biopsy. Both procedures are performed with real-time imaging guidance; however, the main difference between the two is the placement of the biopsy needle. During a transperineal ultrasound-guided prostate biopsy, the needle is inserted through sterilized skin between the scrotum and rectum, then introduced into the prostate. Thus, the risk of sepsis is greatly reduced. Additionally, the transperineal approach allows for better access to the anterior prostate and therefore yields a more comprehensive tissue sample for analysis by a pathologist under a microscope.

Who is a good candidate for a transperineal ultrasound-guided prostate biopsy?

While a transperineal ultrasound-guided prostate biopsy is appropriate for all patients, it can be particularly beneficial for men who have or had:

• A history of infection after a previous transrectal biopsy
• Rectal bleeding complications after a previous transrectal biopsy
• A suspected tumor in the anterior prostate and a previous negative transrectal biopsy
• A history of prostatitis
• Inflammatory bowel disease

Moffitt's approach to prostate biopsy

Moffitt Cancer Center is one of only a few centers in the nation that perform a high volume of ultrasound-guided transperineal prostate biopsies. Our renowned Urologic Oncology Program features a multispecialty team of board-certified surgeons, radiologists, radiation oncologists, pathologists, supportive care specialists and other medical professionals who focus on diagnosing and treating prostate cancer. Working together, these diverse experts reach an accurate diagnosis and develop a tailored treatment plan for each patient. Additionally, our tumor board meets regularly to evaluate and monitor complex cases. These are just some of the many ways we provide outstanding cancer care.

If you would like to discuss your prostate cancer symptoms or diagnosis with a specialist in our Urologic Oncology Program, please contact us at 1-888-663-3488 or complete our new patient registration form online to request an appointment. As Florida’s top cancer hospital, Moffitt has disrupted the traditional patient care model, and we will connect you with an expert as soon as possible. By providing rapid care, we will ensure that you can begin your treatment as soon as possible.

References

American Cancer Society – Key Statistics for Prostate Cancer