MONDAY, Sept. 30, 2024 (HealthDay News) — For patients with suspicion for prostate cancer, transperineal biopsy has similar cancer detection rates as transrectal biopsy but a significantly lower risk for infection, according to a research letter published online Sept. 19 in JAMA Oncology.

Jim C. Hu, M.D., M.P.H., from the New York Presbyterian Weill Cornell Medicine Hospital in New York City, and colleagues randomly assigned patients with suspicion for prostate cancer to clinic-based transperineal biopsy (without antibiotic prophylaxis) or transrectal biopsy (with targeted prophylaxis). A total of 875 patients were randomly assigned from February 2021 through March 2024; 372 and 370 underwent biopsy in the transperineal and transrectal groups, respectively.

The researchers found no infections in the transperineal group versus six infections in the transrectal group in an intent-to-treat analysis (difference, −1.6 percent). Low and similar rates of other complications were seen. Overall, 55 and 52 percent of patients in the transperineal and transrectal groups, respectively, had high-grade cancer (difference, 2.9 percent).

“Transperineal biopsy significantly lowers the risk of infectious complications versus transrectal biopsy,” the authors write. “Transperineal biopsy should be the standard of care for prostate biopsy.”

One author disclosed financial ties to Perineologic and KOELIS.

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