What is it?
A transperineal prostate biopsy is a procedure used to take small samples of prostate tissue to check for prostate cancer. Unlike the older transrectal approach, the biopsy needle passes through the skin between the scrotum and anus (the perineum), which greatly reduces the risk of infection.
Why is it done?
- To investigate a raised PSA (prostate-specific antigen) blood test
- To evaluate an abnormal finding on prostate MRI
- To check a prostate abnormality found during physical exam
- To monitor men at increased risk of prostate cancer
The Procedure:
- Usually performed as a day-stay procedure
- Done under local or general anaesthesia, depending on the number of samples and patient preference
- A needle is guided into the prostate using ultrasound and, if needed, MRI targeting
- Multiple small tissue cores are taken for laboratory analysis
Benefits of the Transperineal Approach:
- Lower infection risk compared with transrectal biopsy
- Improved sampling of the prostate, especially the anterior region
- Can be combined with MRI guidance for more accurate cancer detection
Risks & Considerations:
- Temporary blood in urine, semen, or stool
- Bruising or discomfort in the perineal area
- Difficulty passing urine (rare)
- Urinary tract infection (very rare compared to transrectal biopsy)
- Small risk of bleeding requiring further care
Recovery:
- Most men go home the same day
- Light activity is usually possible within 24 hours
- Symptoms such as mild discomfort or blood in urine/semen typically settle within days to weeks
Why seek advice?
A prostate biopsy is the most accurate way to diagnose prostate cancer. The transperineal method is now preferred in many centres because it is safer and more accurate. Your urologist will discuss whether it is the right test for you.