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Urol Clin North Am. 2017 Nov;44(4):525-534. doi: 10.1016/j.ucl.2017.07.002.

How to Biopsy: Transperineal Versus Transrectal, Saturation Versus Targeted, What's the Evidence?

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Department of Surgery, Central Clinical School, Monash University, 125 Balaclava Road, Caulfield North, Victoria 3161, Australia. Electronic address:


Until recently, prostate biopsy for the detection of prostate cancer has been performed transrectally and in an untargeted sampling fashion. Consequently, the procedure has suffered a small but significant risk of severe morbidity through infection, and low diagnostic accuracy, with undergrading and missed diagnosis being common. MRI is revolutionizing prostate cancer diagnosis by improving detection accuracy via targeted biopsy. Transperineal biopsy is eradicating sepsis as a risk of prostate biopsy, while avoiding the need for broad-spectrum or combination prophylactic antibiotics. This article analyzes the data on the various current methods of performing prostate biopsy and recommends an optimal technique.


MRI; Prostate cancer; Saturation prostate biopsy; Targeted prostate biopsy; Template prostate biopsy; Transperineal prostate biopsy; Transrectal prostate biopsy

[Indexed for MEDLINE]

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