Abstract
BACKGROUND: Prostate cancer (PCa) is the most common neoplasm in men. Transrectal prostate biopsy is the standard for diagnosing PCa, but it presents complications. Transperineal biopsy has gained popularity due to its better detection rates and fewer complications. OBJECTIVE: To compare the efficiency and complication rates between single-access point transperineal prostate biopsy (TPPB) and transrectal prostate biopsy (TRPB) in patients with suspected PCa. MATERIAL AND METHODS: Information was collected and analyzed from 241 patients with suspected PCa, divided into 2 groups: 171 in the TPPB group and 70 in the TRPB group. Pathology results were collected and complications were identified. RESULTS: Out of the 241 patients, 132 had positive biopsies (54.77%) and 109 negative (45.22%). TPPB was positive in 60.2%, compared to 41.4% of TRPB (p = 0.008). Complications in TPPB were hematuria (53.8%), pain (6.4%), hemospermia (6.4%), and acute urinary retention (2.3%). TPPB shown to be a protective factor for complications (odds ratio [OR] 0.028, 95% confidence interval [95% CI] 0.009-0.9; p < 0.001), compared to the TRPB technique (OR 35.5, 95% CI 10.7-117.6; p < 0.001). CONCLUSIONS: TPPB offers a better detection rate for PCa and it should be adopted as the first-choice method for PCa diagnosis, given that it has a lower complication rate and can be performed without the need for bowel preparation or antibiotic prophylaxis.