AB018. SOH25_AB_363. Transrectal ultrasound biopsy versus transperineal biopsy under local anaesthetic: a systematic review and meta-analysis
Urology Session

AB018. SOH25_AB_363. Transrectal ultrasound biopsy versus transperineal biopsy under local anaesthetic: a systematic review and meta-analysis

Gavin Calpin1, Cian Hehir2, Fintan Ryan1, Benjamin MacCurtain2, Diarmaid Moran1, David Galvin1, Kieran Breen1

1Department of Urology, St. Vincent’s University Hospital, Dublin, Ireland2Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland

Background: Transrectal ultrasound (TRUS) biopsy is traditionally used to detect prostate cancer. In recent years, transperineal (TP) biopsy under general anaesthetic has also been used. Studies suggest TP biopsy may be performed under local anaesthetic (LATP) with acceptable complication rates and without compromising cancer detection. We sought to compare TRUS and LATP biopsy.

Methods: A systematic review of randomised controlled trials (RCTs) and prospective studies meeting eligibility criteria was conducted in accordance with the PRISMA guidelines.

Results: Eight studies with 6,138 patients were included. TRUS biopsy was performed in 3,368 patients and LATP biopsy in 2,770. Patient characteristics were comparable in both groups. Infection (4.5% vs. 0.4%, P<0.00001) and sepsis rates were significantly higher in the TRUS group [3.9% vs. 0.0%, odds ratio (OR) 25.17, 95% confidence interval (CI): 4.79–132.34, P=0.0001] while urinary retention rates were comparable (1.7% vs. 1.3%, OR 1.51, 95% CI: 0.79–2.89, P=0.22). Overall cancer detection rates (62.3% vs. 66.1%, OR 0.86, 95% CI: 0.77–0.96, P=0.006) and Gleason grade group 2–5 detection rates were significantly higher in LATP biopsy (45.2% vs. 51.7%, OR 0.79, 95% CI: 0.70–0.89, P<0.0001). Gleason grade group 1 detection rates were comparable (17.1% vs. 15.3%, OR 1.16, 95% CI: 0.99–1.37, P=0.07).

Conclusions: LATP biopsy is associated with lower rates of infection and comparable rates of urinary retention compared to TRUS biopsy. LATP biopsy also detects a higher incidence of clinically significant prostate cancer.

Keywords: Transrectal ultrasound biopsy (TRUS biopsy); transperineal biopsy under local anaesthetic (LATP biopsy); prostate cancer; complications; cancer detection rates

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab018
Cite this abstract as: Calpin G, Hehir C, Ryan F, MacCurtain B, Moran D, Galvin D, Breen K. AB018. SOH25_AB_363. Transrectal ultrasound biopsy versus transperineal biopsy under local anaesthetic: a systematic review and meta-analysis. Mesentery Peritoneum 2025;9:AB018.

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