Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer: a systematic review and meta-analysis

World J Surg Oncol. 2019 Feb 13;17(1):31. doi: 10.1186/s12957-019-1573-0.


Background: Because conventional prostate biopsy has some limitations, optimal variations of prostate biopsy strategies have emerged to improve the diagnosis rate of prostate cancer. We conducted the systematic review to compare the diagnosis rate and complications of transperineal versus transrectal prostate biopsy. We searched for online publications published through June 27, 2018, in PubMed, Scopus, Web of Science, and Chinese National Knowledge Infrastructure databases. The relative risk and 95% confidence interval were utilized to appraise the diagnosis and complication rate. The condensed relative risk of 11 included studies indicated that transperineal prostate biopsy has the same diagnosis accuracy of transrectal prostate biopsy; however, a significantly lower risk of fever and rectal bleeding was reported for transperineal prostate biopsy. No clue of publication bias could be identified.

Short conclusion: To conclude, this review indicated that transperineal and transrectal prostate biopsy have the same diagnosis accuracy, but the transperineal approach has a lower risk of fever and rectal bleeding. More studies are warranted to confirm these findings and discover a more effective diagnosis method for prostate cancer.

Keywords: Complication; Diagnosis accuracy; Prostate biopsy; Transperineal; Transrectal.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biopsy, Large-Core Needle / adverse effects
  • Biopsy, Large-Core Needle / methods*
  • Fever / epidemiology
  • Fever / etiology
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Male
  • Perineum / surgery
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Prognosis
  • Prostate / diagnostic imaging
  • Prostate / pathology*
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / pathology
  • Rectum / blood supply
  • Rectum / diagnostic imaging
  • Rectum / surgery
  • Ultrasonography, Interventional