Transperineal Biopsy for Prostate Cancer

UF Health Urology now offers patients the option to have a transperineal biopsy for prostate cancer. We are one of a few places in the country offering this new, safer and more accurate method of prostate biopsy, as opposed to the older transrectal prostate biopsy method. Only 5-10 minutes longer than the old approach, the transperineal biopsy is a great option for most all patients needing a prostate biopsy.

What is a transperineal prostate biopsy?

Transperineal biopsy is a type of prostate biopsy and a method of evaluating for prostate cancer. With this ultrasound-guided prostate biopsy, your doctor will place a biopsy needle through the skin and into the prostate between the scrotum and rectum. The sampled tissue will be sent to the lab and evaluated by a pathologist to look for prostate cancer cells. This type of prostate biopsy is an outpatient procedure that takes 30-45 minutes to complete. This targeted biopsy approach is much more accurate than the traditional transrectal method.

Why should patients choose a transperineal biopsy?

The alternative to a transperineal prostate biopsy is a transrectal biopsy, the main difference being how the needle is placed into the prostate. A transrectal biopsy is the overwhelming approach with over 99% of biopsies in performed this way nationally, however, UF Health urology now prefers to use the transperineal prostate biopsy approach. Transperineal needles go through sterilized skin, while transrectal needles present a higher risk of infection because they pass through the rectum. Using a transperineal approach greatly reduces the risk of infection when compared to a traditional transrectal biopsy approach. The below video shows why a transperineal biopsy was the choice for UF Health urology patient, Andy.

Who is a candidate for a transperineal biopsy?

• Patients with a life expectancy greater than 10 years
  
• Patients with a concern for prostate cancer, this may include patients with:
• Elevated prostate-specific antigen (PSA) levels
• Abnormalities on digital rectal exam
• Lesions seen on imaging, micro-ultrasound, MRI or PSMA

What are the side effects of a transperineal biopsy?

Side effects of a transperineal biopsy generally include:

• Blood in the urine (hematuria)
• Ejaculate (hematospermia)

Patients can experience discomfort during the placement of the anesthetic. This feeling is like the burning sensation when a dentist works on a tooth. Unlike the transrectal prostate biopsy approach, there is no risk of rectal bleeding as the needle does not go through the rectal wall.

What can I expect after a transperineal biopsy?

At the University of Florida Health, we use two imaging methods, MRI and micro-ultrasound. These procedures locate cancers before biopsy. Our innovative method is exceptionally accurate in determining the presence of cancer. You will meet with our team one to two weeks after the biopsy to discuss the results. Prostate cancer is given a grade called a Gleason score after the prostate cancer biopsy. This score varies for our patient and will help determine the correct treatment course.

Our urologic oncology team will then decide if further tests are needed to get you started on a personalized treatment plan. UF Health offers leading-edge treatment options for prostate cancer such as:

• Focal therapy options including cryoablation, radiofrequency ablation and high-intensity focused ultrasound (HIFU)
  
• Radical prostatectomy options (traditional and robotic-assisted)
• Proton therapy
• Immunotherapy
• Or a combination of treatments

Learn about the UF Health Urologic Cancer Center and how our expert team of prostate cancer physicians can help you: Prostate Cancer | UF Health Urologic Cancer Center | Urologic Cancers | UF Health, University of Florida Health.