Transperineal prostate biopsy minimizes risk of infection, may increase detection rate

Loyola Medicine is among the first centers to offer a new minimally invasive prostate biopsy that minimizes the risk of infection and may increase the cancer detection rate.

It's called the transperineal prostate biopsy.

A urologist may recommend a biopsy if a digital rectal exam or PSA blood test suggests the patient may have prostate cancer. A needle is used to collect prostate tissue samples, which are examined by a pathologist for cancer.

In the traditional approach, called transrectal, the physician passes the biopsy needle through the rectal lining to reach the prostate. This risks introducing fecal material and bacteria into the prostate. Patients must take antibiotics, which have possible side effects such as allergic reactions and upset stomach.

But even after taking antibiotics, as many as 5 percent of men undergoing transrectal biopsies experience infections, ranging from mild urinary tract infections to life-threatening sepsis.

In the new approach, the biopsy needle is passed through the perineum, an area of skin between the base of the scrotum and the rectum. No fecal material is introduced, and the risk of infection is so low that no antibiotics are needed.

The transperineal approach also may be more accurate than the transrectal approach in detecting tumors, because the physician can insert the needle into the prostate from more than one direction, said Loyola Medicine urologic surgeon Gopal Gupta, MD.

A transperineal biopsy can be done in a doctor's office in less than 10 minutes, and requires only local anesthesia. The patient experiences little or no pain afterwards, Dr. Gupta said.

Loyola is offering the transperineal biopsy along with a new technology called UroNav®, which fuses ultrasound and magnetic resonance imaging (MRI) to create a detailed, three-dimensional view of the prostate. This improved view helps physicians perform biopsies with much higher precision, and increases prostate cancer detection, Dr. Gupta said.

In 2014, Loyola became the first center in Illinois to offer MRI-ultrasound imaging, and Loyola today is among the centers with the most experience with the technology.

By combining the transperineal approach with the MRI-ultrasound imaging system, we are able to offer our patients prostate cancer biopsies that are both less invasive and more accurate."
Dr. Gopal Gupta, urologic surgeon, Loyola Medicine

Loyola Medicine