Journal: Scientific reports
This study evaluated the cancer detection rate (CDR), safety, and tolerability of transperineal prostate biopsy (TPPB) performed under local anesthesia (LA) without antibiotic prophylaxis in an outpatient setting using a freehand MRI/ultrasound fusion technique.
Among 538 patients who underwent TPPB without antibiotics:
- Overall CDR: 61.7%
- Clinically significant prostate cancer detected: 47.4%
- No infectious complications reported.
- Patient-reported pain: Low (mean VAS 2.7)
- 91.6% experienced no or mild discomfort.
- Complications were rare (1.1%), mostly urinary retention linked to larger prostate volume.
Combining systematic and targeted biopsies increased diagnostic accuracy.
The findings support freehand TPPB under LA without antibiotics as a safe, effective, and well-tolerated outpatient procedure with high diagnostic yield and no infectious risks.
This approach presents a cost-efficient alternative to transrectal biopsy, especially amid rising antibiotic resistance.