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Abstract
The incidence of prostate cancer has shown a significant increase, highlighting the importance of early diagnosis. Current practice considers histological diagnosis a necessity in the majority of the cases. The limitations of transrectal biopsies led to the development of the promising transperineal prostatic biopsies. The latter offers a safer approach by avoiding the rectum, utilizing brachytherapy template grid to detect anterior zone disease and provides accurate prostatic mapping by systematically sampling the whole gland. It also helps to direct biopsies based on images obtained from previous prostate scanning and identify those eligible for focal therapy to direct focal treatment accurately. The current literature provides enough reassurance that transperineal template biopsies are effective, efficient and superior to the traditional and inaccurate transrectal biopsies. The absence of consensus on the technical aspect of template biopsies is a drawback, yet it highlights the need to develop robust guidelines to standardize the procedure.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Transperineal template biopsies of the prostate (TTBP) is a safe, effective and useful diagnostic tool for prostate cancer, especially in those with anteriorly located disease.
The relatively smaller risk of postoperative complications is likely to make TTBP more appealing to both clinicians and patients.
A combination of prostate mapping and 3D reconstruction of the prostate enables the appropriate selection of management strategy, particularly important in planning for focal therapy of prostate cancer.
Although the absence of consensus on the technical aspect of TTBP is considered a drawback, it highlights the need to develop robust guidelines to help standardize this procedure as much as possible.
New and up-to-date risk stratification tools should be in place, taking into account histopathological information from mapping or multiparametric MRI-guided transperineal biopsies.