• Danny Rabah, Waleed Al-Taweel, Farrukh Khan, Mostafa Arafa, Shahbaz Mehmood, Alaa Mokhtar, and Karim Farhat.
• From the Department of Surgery (Rabah, Khan), College of Medicine; from the Cancer Research Chair (Rabah, Arafa, Farhat), King Saud University, and from the Department of Urology (Rabah, Al-Taweel, Mokhtar), King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia.
• Saudi Med J. 2021 Jun 1; 42 (6): 649654649-654.

ObjectivesTo compare transperineal biopsies (TPBx) with transrectal ultrasound-guided biopsy (TRUSBx) in order to provide evidence, making clinicians able to select the appropriate biopsy approach under different conditions.MethodsA comparative prospective study, conducted in King Khalid University Hospital (KKUH) and King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia, between March 2019 and February 2020. All patients with raised prostate-specific antigen or atypical digital rectal examination findings were subjected to multi-parametric magnetic resonance imaging (MRI). Those with positive findings were referred to targeted fusion- guided biopsy either TPBx or TRUSBx, randomly. Complication rate, cancer detection rate, and procedure time were recorded.ResultsTransperineal biopsies and TRUSBx had an equivalent complication rate. However, both case detection rate and clinically significant cancer detection rate were significantly higher in TPBx versus TRUSBx (45.1% versus 29.1%, p=0.003; and 71.8% versus 43.7%, p=0.002; respectively). Transperineal biopsies was a longer procedure than TRUSBx (41.2±0.7 min versus 13±2.3 min, p=0.0001).ConclusionNo difference in complication rate was detected between the 2 procedures; however, TPBx was more effective for cancer detection in general and clinically significant cancer detection in particular.Copyright: © Saudi Medical Journal.

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