Transperineal Prostate Biopsy
The Key Things to Know:
A transperineal prostate biopsy is a minimally invasive procedure used to sample tissue from the prostate gland. It is performed through the skin between the scrotum and anus using fine needles guided by ultrasound. This approach offers improved accuracy and a lower risk of infection compared to older transrectal techniques.
What It Is
This procedure involves using ultrasound guidance to insert biopsy needles through the perineal skin (between the scrotum and anus) into the prostate to obtain small tissue samples. These samples are analysed under a microscope to check for prostate cancer or other abnormalities. The test is usually performed as a day procedure under general anaesthetic.
When It's Needed
Your urologist may recommend a transperineal prostate biopsy if: - Your PSA blood test is elevated or rising over time - An MRI scan of the prostate shows a suspicious area - There are abnormal findings on rectal examination - You require repeat testing after an inconclusive or negative biopsy, but ongoing concern remains.
Surgery Diagram
Benefits
Increased accuracy in detecting clinically significant prostate cancer
Reduced risk of infection
because the needles do not pass through the bowel
Suitable for both targeted (MRI fusion)
and systematic sampling
Usually performed as a same-day procedure with quick recovery
Risks
Although generally safe, all procedures carry some risks:
Temporary blood in the urine, semen, or stool for a few days
Mild perineal bruising or discomfort
Urinary retention (difficulty passing urine) in a small number of cases
- Infection risk is very low but can occur; antibiotics are usually given before the procedure
Rarely, temporary difficulty with urination may require a short-term catheter
What to Expect After the Procedure
You’ll usually go home the same day once you can pass urine. Mild discomfort or stinging is common and improves over a few days. You may notice some blood in urine or semen for up to 4-6 weeks - this is normal. Avoid strenuous exercise for 48 hours and drink plenty of water. Most men return to normal activities within a day or two. Biopsy results are generally available within one to two weeks, and we will discuss them at follow-up.
FAQs
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Yes. Transperineal biopsy uses a skin approach rather than through the rectum, which significantly lowers infection risk.
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Local anaesthetic and sedation make it very tolerable. Most patients describe only mild discomfort.
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Antibiotics are given at the time of the biopsy only. Normally, a longer course of anti-biotics are not required.
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If you had sedation, you’ll need someone to drive you home. If local anaesthetic only, you can usually drive yourself.
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