Comparison Of Prostatic Biopsies:Transrectal Approach And Transperineal Approach

Objective: To compare the application value and safety between ultrasound-guided transrectal(TR)and transperineal(TP)approaches in prostate biopsy for prostate cancer detection.Methods: A retrospective study was conducted on 271 consecutive suspected prostate cancer patients given ultrasound-guided TR(n=145)and TP(n=126)prostate biopsy,and the detection rate of prostate cancer and post-biopsy complications were compared between TR and TP.Results: The total detection rate of prostate cancer in the TR and TP group was 35.86% and 37.30% respectively.when PSA was located at different intervals(PSA<10 ng/ml、10 ng/ml≤PSA≤20 ng/ml、PSA>20 ng/ml),and the detection rates of prostate cancer in the TR and TP group were 13.04%、14.58%,20.75%、29.72%,76.08% and 70.73% respectively.when The volume of the prostate was located at different intervals(20ml≤V<25ml、25ml≤V<50ml、50ml≤V<75ml、V≥75ml),and the detection rates of prostate cancer in the TR and TP group were 69.23%、66.66%,41.17%、44.18%,21.05%、26.82%,21.73% and 32.25% respectively.The difference of all of the above comparisons was not statistically significant(P>0.05).The overall incidence of post-biopsy complications in the TR and TP group was 44.13% and 3.17% respectively.The incidence of infection,hematuria,urine and urine retention in the TR group were 14.48%、18.62%、4.82% and 4.82%,respectively,which were significantly higherthan those of the TP group 0.79%、2.38%、0% and 0%,and there were significant statistics differences(P<0.05).The incidence of Pain requiring medication and transient syncope in TR group were all 0.68%,while that in TP group were all 0.There were no significant difference between two groups(P>0.05).According to the Clavien-Dindo complication classification system,the I and II complications of the TR and TP group were 28.96%、2.38%,12.41% and 0.79%,respectively.There were obvious differences(P<0.05).The III,IV and V complications of TR and TP group were 0.68%、0,2.06%、0,0、0,respectively,and there were no significant difference(P>0.05).Conclusions: The detection rate of PCa by TP prostate biopsy is no less than that of TR approach,and it is significantly better than the latter in the safety of post-biopsy complications,so it is worthy of clinical promotion.