Advantages of single-puncture transperineal saturation biopsy of prostate: analysis of outcomes in 125 patients using our scheme

Int Urol Nephrol. 2015 May;47(5):735-41. doi: 10.1007/s11255-015-0967-3. Epub 2015 Apr 8.


Purpose: Stereotactic biopsy has improved prostate cancer detection. Although the new approach is superior, standard procedure is still useful in a cohort of patients in whom MRI is not available. The standard saturation biopsy technique is still debatable. We describe our technique and analyze its outcomes.

Materials and methods: One hundred twenty-five patients underwent saturation biopsy through a single transperineal access. Mean age was 64.73 year, mean PSA was 9.49 ng/ml, mean PSA density was 0.184, and mean prostate volume was 57.95 g. All patients underwent at least one previous prostatic biopsy: 24.8% of cases had diagnosis of atypical small acinar proliferation, 39.2% of cases had multifocal high-grade prostatic intraepithelial neoplasia, and 36% of cases had inflammation or benign prostatic hyperplasia.

Results: The detection rate was 38.4%. Prostate cancer occurred in 61.3% of patients with previous ASAP (p < 0.007). Cancer detection rate decreased with increasing number of previous biopsy and with increasing prostate volume (p < 0.001) and increased with increasing PSA density (p = 0.03). No major complications were reported.

Conclusion: The traditional saturation biopsy may be useful when targeted biopsy cannot be used. Our technique is accurate for cancer detection. It can offer some advantages in comparison with other approaches.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / adverse effects
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Organ Size
  • Perineum
  • Prostate / pathology*
  • Prostate-Specific Antigen
  • Prostatic Hyperplasia / pathology*
  • Prostatic Intraepithelial Neoplasia / pathology*
  • Prostatic Intraepithelial Neoplasia / therapy
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / therapy
  • Punctures
  • Reoperation
  • Retrospective Studies


  • Prostate-Specific Antigen