Transperineal Prostate Biopsy

The prostate gland is a male reproductive organ that helps in the production of semen. It is situated just under the bladder and in front of the anal passage (rectum). A sample of prostate tissue for laboratory investigation (biopsy) may sometimes be needed to look for cancer or other abnormalities causing difficulty with urination or abdominal pain. Prostate biopsies are usually performed through the rectum (trans-rectal approach) due to its proximity, but this procedure may result in inadequate sampling of certain parts of the prostate and carries a risk of serious infection due to the inability to sterilise the rectal wall. A transperineal prostate biopsy, through the skin between the scrotum and anus is recommended to overcome these drawbacks.

A prostate biopsy is ordered in the following situations:

• Your doctor finds the prostate abnormal on palpating through the rectum
• You have a high prostate specific enzyme in the blood, indicative of prostate cancer
• To monitor existing prostate cancer that does not require treatment yet
• To identify other prostate conditions such as benign prostatic hyperplasia (enlargement) and prostatitis (bacterial infection of the prostate)

Transperineal prostate biopsy is performed under local or general anaesthesia. The ultrasound imaging probe is lubricated and inserted through the anus into the rectum. It creates images that guide your doctor throughout the procedure. The skin over the perineum is sterilised and biopsy needles are inserted through this region to enter different parts of the prostate gland, including those inaccessible through the trans-rectal approach. Multiple biopsies are thus obtained. These are sent to the laboratory for further examination.

As with any procedure, a transperineal prostate biopsy may be associated with certain risks such as infection, bleeding and damage to the urethra, which can result in a temporary difficulty with urination.