Ultrasound-Guided Transperineal Versus Transrectal Prostate Aspiration Biopsy in Diagnosing Prostate Cancer: An Observational Comparison Study.

[BACKGROUND] Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. However, the effect of the optimal puncture approach on diagnostic yield and patient outcomes remains controversial.

[OBJECTIVE] To compare the diagnostic effectiveness and clinical outcomes of ultrasound-guided transperineal versus transrectal prostate aspiration biopsy in patients suspected of prostate cancer.

[METHODS] A retrospective analysis was conducted on 150 patients who underwent prostate biopsy at our hospital between February 2020 and August 2024. Patients were divided into transperineal (n = 62) and transrectal (n = 88) groups. Key outcomes including cancer detection rate, complications, pain (VAS), and negative emotions were compared, with p < .05 indicating a statistically significant difference.

[RESULTS] No significant difference was found between the transperineal and transrectal groups in the detection rates of prostate cancer (51.61% versus 43.18%), chronic prostatitis (12.90% versus 18.18%), or benign prostatic hyperplasia (35.48% versus 38.64%). Transperineal biopsy required longer puncture time (22.92 ± 2.02 min versus 19.70 ± 1.93 min), but resulted in fewer overall complications (20.97% versus 38.64%), lower post-procedure pain scores (VAS: 2.82 ± 1.13 versus 3.68 ± 1.14), and lower anxiety (HAMA: 10.34 ± 1.29 versus 12.55 ± 1.44) and depression scores (HAMD: 10.33 ± 1.68 versus 12.90 ± 1.38).

[CONCLUSION] Both ultrasound-guided transperineal and transrectal prostate biopsies are effective diagnostic methods for prostate cancer. Transperineal biopsy offers advantages in reducing postoperative complications, pain, and negative emotional responses, supporting its preferential use in selected patients.