Transperineal biopsy of the prostate—is this the future?

Transperineal prostate biopsy provides better anteroapical sampling than transrectal ultrasonography (TRUS)-guided biopsy, leading to improved cancer detection ratesAlthough usually used as a confirmatory test after negative TRUS-guided biopsy, transperineal biopsy shows promise as an initial investigationTransperineal biopsy frequently requires higher levels of anaesthesia relative to TRUS-guided biopsy, especially when >10–12 cores are takenIn patients at high risk of infection (such as those with diabetes mellitus or who recently travelled to countries with high prevalence of antimicrobial resistance), transperineal biopsy is safer than TRUS-guided biopsy in terms of reducing sepsisMultiparametric MRI technology improves the cancer detection rate and accuracy of disease grading in needle biopsy and enables targeted biopsy, which reduces the risk of complications