Editing Prostate Biopsy (section)

== Approach: Transrectal vs. Transperineal ==

* '''Cancer detection rates associated with transrectal versus transperineal biopsy route are not significantly different.[https://pubmed.ncbi.nlm.nih.gov/23659877/]'''

=== Transrectal biopsy ===

* Trajectory of needle is through rectum and into prostate
*'''Advantages[https://pubmed.ncbi.nlm.nih.gov/23659877/]'''
*#'''Patient preference/comfort'''
*#'''Patient cannot be placed into the lithotomy position'''
*#'''Clinician training/experience or lack of appropriate equipment for the transperineal approach.''' 
=== Transperineal biopsy ===
* Trajectory of needle is through skin (avoids rectum) and into prostate
*'''Advantages (3):'''
*# '''Reduced infectious and other complication rates'''
*# '''May detect anterior and apical cancers at a higher rate''' (prospective, randomized data are lacking and existing data are contradictory.)'''[https://pubmed.ncbi.nlm.nih.gov/23659877/]'''
*# '''Can be done in patients without a rectum''' (e.g., surgical extirpation, congenital anomaly)
* '''Disadvantages (1):'''
*# '''May need for more anesthesia''', but can be done under local anesthetic
*'''<span style="color:#ff0000">Transperineal biopsies may have some value in patients (3):[https://pubmed.ncbi.nlm.nih.gov/23659877/]</span>'''
*# '''<span style="color:#ff0000">Infectious complications with a prior biopsy</span>'''
*#'''<span style="color:#ff0000">Higher risk for biopsy-related infection</span>'''
*#'''<span style="color:#ff0000">Anterior lesions that may not be as easily accessible transrectally</span>'''