E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, compares transperineal prostate biopsy to transrectal ultrasound (TRUS)-guided prostate biopsy, listing the pros and cons of each. He establishes that the transperineal approach is superior to the transrectal one in minimizing risk of sepsis and urinary tract infection, although transperineal biopsy is more associated with urinary retention. Dr. Crawford goes on to discuss the comparative cost and convenience of the techniques, observing that TRUS-guided biopsy is typically far less expensive and that more doctors have the requisite experience and equipment to perform such a biopsy as opposed to a transperineal one. Dr. Crawford suggests that the transrectal approach is currently easier than the transperineal one for most urologists and patients, but notes that urologists may want to consider tailoring their technique to an individual patient’s particular needs and risk factors. However, Dr. Crawford concludes by introducing a demonstration of a transperineal 3D mapping biopsy, suggesting that this may be disruptive technology capable of transforming prostate cancer care.

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