Transperineal and transrectal prostate biopsy differ mainly in the route the biopsy needle takes to reach the prostate—not in the underlying purpose of the biopsy. A transperineal biopsy passes the needle through disinfected perineal skin, while a transrectal biopsy passes the needle through the rectal wall. Both routes can sample MRI targets and detect clinically significant prostate cancer. The most consistent clinical difference is infection exposure: transperineal biopsy avoids rectal flora and current European Association of Urology guidance prefers it for its lower infectious risk and antibiotic-stewardship advantages. Cancer detection, however, is broadly comparable overall when modern techniques are used.
“Transperineal vs transrectal” describes access route. It does not tell you whether the biopsy is MRI-targeted, systematic, cognitive, fusion-guided or perilesional. Either route can be combined with those sampling strategies. To understand the complete procedure first, see What Is a Prostate Biopsy?.
01What Is the Difference Between Transperineal and Transrectal Prostate Biopsy?
Transperineal biopsy enters through the skin below the scrotum
In a transperineal prostate biopsy, a biopsy needle reaches the prostate through the perineum—the skin between the scrotum and anus.
The usual sequence is:
- the perineal skin is disinfected;
- local anesthesia is administered;
- an ultrasound probe visualizes the prostate;
- the needle enters through one or more small skin punctures;
- cores are directed to the intended prostate regions or MRI targets.
The needle does not have to pass through the rectal lumen.
Transrectal biopsy enters through the rectal wall
In a transrectal prostate biopsy, an ultrasound probe is placed into the rectum and the biopsy needle passes from the rectum through the rectal wall into the prostate.
This provides a short anatomical route to the posterior prostate and has been used extensively for decades.
Modern transrectal biopsy can be:
- systematic;
- MRI-targeted;
- software fusion-guided;
- or combined with broader sampling.
The ultrasound probe position does not determine the needle route
This is a common source of confusion.
A transperineal biopsy can still use a transrectal ultrasound probe.
The ultrasound probe supplies the image.
The term transperineal describes where the biopsy needle enters.
Can both methods be performed under local anesthesia?
Yes.
Modern transperineal biopsy no longer inherently requires general anesthesia.
Both routes can be performed under local anesthesia in outpatient settings.
Additional sedation or deeper anesthesia may be used according to:
- number of planned cores;
- patient preference;
- anticipated discomfort;
- prostate anatomy;
- local biopsy technique;
- and institutional practice.
Does one route take tissue differently once the needle is inside the prostate?
Not necessarily.
The same spring-loaded core-biopsy principle can be used with either route.
What changes is the geometry of access.
The biopsy can still be directed toward:
- a lesion identified on prostate MRI;
- an abnormal region classified with PI-RADS;
- tissue immediately surrounding that lesion;
- or systematic prostate regions.
Do not confuse “transperineal” with “MRI-targeted.” Route answers how the needle enters. MRI targeting answers which tissue the needle is directed toward. A biopsy can be transperineal and targeted, transrectal and targeted, or systematic through either route.
02Which Route Has Lower Infection Risk, and How Do Other Complications Compare?
Infection is the clearest difference between the two routes
The rectum contains a dense population of bacteria.
A transrectal biopsy needle passes directly through that bacterial environment before entering prostate tissue.
A transperineal biopsy instead passes through surgically disinfected skin.
That anatomical difference explains why infection prevention has become the major reason many centers have moved toward transperineal biopsy.
What do large evidence reviews show?
Current EAU prostate-cancer guidance summarizes randomized evidence showing significantly more infectious complications after transrectal biopsy.
Across eight randomized studies involving 1,596 men, the guideline reports:
- 48 infectious events among 789 men undergoing transrectal biopsy;
- 22 events among 807 men undergoing transperineal biopsy;
- a relative risk of approximately 2.48 for infectious complications with the transrectal approach in that analysis.
The same guideline cites a systematic review of 165 studies involving more than 162,000 patients in which reported sepsis rates were approximately:
- 0.1% after transperineal biopsy;
- 0.9% after transrectal biopsy.
These are population estimates across many different centers and protocols rather than a prediction for an individual patient.
What did the PREVENT randomized trial find?
The final PREVENT trial compared office-based:
- transperineal biopsy without routine antibiotic prophylaxis;
- with transrectal biopsy using rectal culture screening and targeted antibiotic prophylaxis.
Among men who underwent biopsy, the final JAMA Oncology report found:
- 0 infections among 372 transperineal patients;
- 6 infections among 370 transrectal patients—1.6%.
The difference was statistically significant in the final analysis.
Did every randomized trial find a difference?
No.
The ProBE-PC randomized trial found similar 30-day composite infectious complication rates:
- 2.7% after transperineal biopsy;
- 2.6% after transrectal biopsy.
No participant developed sepsis in either group.
This does not erase the broader evidence favoring the cleaner transperineal route, but it shows why exact infection percentages depend on:
- how an infection is defined;
- follow-up duration;
- patient selection;
- local antibiotic protocols;
- rectal preparation;
- and local bacterial resistance.
Are antibiotics needed for transperineal biopsy?
Current EAU guidance states that perioperative antibiotic prophylaxis may be omitted in transperineal biopsy patients who do not have important infectious risk factors.
That recommendation is not permission for patients to decide this themselves.
Local protocols may still use antibiotics in patients with factors such as:
- diabetes;
- urinary tract infection;
- indwelling urinary devices;
- immunosuppression;
- previous infectious complications;
- or other individual risk considerations.
What infection precautions are used for transrectal biopsy?
Current EAU recommendations include:
- rectal cleansing with povidone-iodine;
- antimicrobial prophylaxis;
- and antibiotic strategies tailored to local resistance patterns.
The EAU lists culture-directed prophylaxis based on rectal swab or stool culture as a preferred stewardship option, with augmented prophylaxis as another strategy where appropriate.
What about urinary retention?
Urinary retention can occur after either route because biopsy can produce:
- temporary prostate swelling;
- bleeding;
- and irritation around the urethra.
Risk depends more on factors such as:
- baseline urinary obstruction;
- prostate size;
- number of tissue cores;
- and the extent of sampling
than on a simple assumption that one route always causes retention and the other does not.
What did PREVENT show about retention?
In the final PREVENT trial:
- urinary retention requiring intervention occurred in 0.3% of the transperineal group;
- and 1.1% of the transrectal group.
The difference was not statistically significant.
Which route causes more bleeding?
Both routes can cause:
- blood in urine;
- blood in semen;
- local bruising;
- and small amounts of procedure-related bleeding.
The pattern differs anatomically.
Rectal bleeding is primarily associated with the transrectal route because the rectal wall is punctured.
Transperineal biopsy can instead produce:
- small puncture-site bleeding;
- perineal bruising;
- or local skin tenderness.
Which route hurts more?
Pain data are mixed and depend heavily on anesthesia technique.
Transperineal biopsy requires effective anesthesia of the perineal skin and deeper tissues.
Transrectal biopsy commonly uses periprostatic local anesthetic blockade.
Modern studies show both routes can be performed tolerably under local anesthesia.
Urgent post-biopsy warning: fever, shaking chills, feeling severely unwell, inability to urinate, heavy persistent bleeding or progressive severe pain requires prompt medical assessment regardless of biopsy route.
03Does Transperineal Biopsy Detect More Prostate Cancer Than Transrectal Biopsy?
Overall clinically significant cancer detection is broadly comparable
The strongest current evidence does not support a simple claim that one route always detects more clinically significant prostate cancer.
EAU guidance notes that an earlier meta-analysis found higher sensitivity with MRI-targeted transperineal biopsy, but subsequent randomized trials did not demonstrate consistent overall superiority.
What did PREVENT show for cancer detection?
In the final PREVENT randomized trial, Grade Group 2–5 prostate cancer was found in:
- 55% of men undergoing transperineal biopsy;
- 52% undergoing transrectal biopsy.
The difference was not statistically significant.
The clinically important message is:
the major demonstrated advantage in that trial was infection reduction, not a major difference in clinically significant cancer detection.
Does route matter for where the tumor is located?
Potentially.
Needle geometry differs between the two approaches.
The transperineal route offers direct access to:
- anterior prostate tissue;
- anterior transition-zone lesions;
- apical regions;
- and lesions that may be awkward to approach from the rectum.
The transrectal route naturally approaches posterior tissue from immediately behind the prostate.
What has research shown about anterior and posterior cancers?
Current EAU guidance summarizes randomized evidence suggesting that the relative detection performance may vary by tumor location.
In the PERFECT trial:
- clinically significant anterior tumors were detected more frequently through the transperineal route;
- while posterior tumors were detected more frequently in the transrectal arm.
This should not be interpreted to mean that either route is incapable of reaching the opposite region.
MRI targeting, operator skill and needle planning remain important.
Does MRI matter more than route for cancer detection?
In many contemporary diagnostic pathways, MRI lesion identification and the sampling strategy can matter as much as the access route.
The clinically relevant questions become:
- Was high-quality MRI performed?
- Was the lesion accurately localized?
- Was the target sampled adequately?
- Were adjacent regions sampled where indicated?
- Was the operator experienced with the chosen route?
A well-performed transrectal targeted biopsy can be more informative than a poorly targeted transperineal procedure, and vice versa.
Can both routes perform MRI-ultrasound fusion biopsy?
Yes.
Software can register a previously acquired MRI with live ultrasound during either transperineal or transrectal biopsy.
The forthcoming guide on MRI-targeted biopsy addresses the targeting method itself separately from the access route.
Route is only one part of biopsy quality. Cancer detection depends on MRI quality, lesion localization, needle placement, number and distribution of cores, pathology processing and operator experience. The infection advantage of transperineal biopsy is clearer than any claim of universal cancer-detection superiority.
04When Is Transperineal or Transrectal Biopsy Used in Clinical Practice?
Current European guidance prefers transperineal biopsy
Current EAU prostate-cancer guidance recommends:
“Perform prostate biopsy using the transperineal approach due to the low risk of infectious complications and better antibiotic stewardship.”
That is a strong recommendation within the EAU framework.
The reasoning combines:
- lower overall infectious exposure;
- similar clinically significant cancer detection in modern trials;
- feasibility under local anesthesia;
- and reduced dependence on antimicrobial prophylaxis.
Does the AUA require transperineal biopsy?
No.
The AUA/SUO early-detection guideline states that clinicians may use either a transrectal or transperineal route.
That recommendation reflects:
- comparable detection data;
- differences in local expertise;
- availability of biopsy equipment;
- and variation in patient-specific circumstances.
Guidelines are not identical. EAU guidance currently prefers the transperineal route, primarily for infection prevention and antibiotic stewardship. AUA guidance recognizes both transperineal and transrectal biopsy as acceptable. This is a difference in recommendation strength and implementation—not evidence that transrectal biopsy cannot diagnose prostate cancer effectively.
When may transperineal biopsy be particularly attractive?
Clinical reasons may include:
- a desire to minimize infectious exposure;
- prior infection after transrectal biopsy;
- known or suspected resistant rectal organisms;
- a suspicious anterior prostate lesion;
- repeat biopsy after prior negative sampling;
- need for extensive prostate mapping;
- local expertise with office-based transperineal biopsy.
When may transrectal biopsy still be used?
Transrectal biopsy may remain reasonable where:
- the clinical team has substantial expertise with the technique;
- appropriate infection-control and prophylaxis protocols are in place;
- the necessary transperineal equipment or training is not available;
- patient anatomy or circumstances favor that route;
- and the patient understands the relative risks.
Does a previous transrectal biopsy mean future biopsies must also be transrectal?
No.
The route can change.
A man who previously underwent transrectal biopsy can undergo a later transperineal biopsy if clinically appropriate.
This may occur during:
- repeat biopsy for persistent PSA concern;
- active surveillance;
- re-evaluation of an MRI lesion;
- or a change in local biopsy practice.
Does a previous negative biopsy change the importance of MRI?
Yes.
When suspicion persists after a previous negative biopsy, MRI can help identify:
- an anterior lesion missed by previous systematic sampling;
- a small high-suspicion target;
- or another region deserving directed tissue sampling.
The meaning of an MRI-defined target is explained in What Is a Prostate Lesion?.
What if the MRI is negative?
A negative MRI can sometimes support avoiding biopsy when overall clinical suspicion is low.
Current EAU guidance considers factors such as:
- PSA density;
- family history;
- clinical examination;
- and overall pre-test risk.
For example, a negative MRI with low PSA density can be substantially more reassuring than the same negative MRI in a man with a high PSA density and strong hereditary risk.
What should a patient ask before choosing a biopsy route?
Useful questions include:
- Which biopsy route does this center use most often?
- Why is that route recommended in my case?
- Will my MRI lesion be specifically targeted?
- Will perilesional or systematic cores also be taken?
- What type of local anesthesia or sedation will be used?
- What is this center’s infection rate?
- Will antibiotics be needed?
- How many cores are expected?
- What is the urinary-retention risk for my prostate size and symptoms?
- What symptoms after biopsy should trigger urgent contact?
Should someone choose a biopsy route based only on infection risk?
No.
Infection risk is important, but an appropriate biopsy also needs to:
- reach the relevant prostate tissue;
- accurately target MRI findings;
- provide enough pathology material;
- fit the patient’s medical history;
- and be performed by a team experienced with that technique.
How does the biopsy route fit into the full prostate-cancer pathway?
The route is only one technical step in a larger diagnostic sequence:
risk / PSA → MRI → lesion assessment → biopsy decision → biopsy route and targeting → pathology → grade and stage.
That pathway begins with the PSA test and is brought together in How Prostate Cancer Is Diagnosed.
The clinically useful comparison is not “new method versus old method.” Both routes can obtain diagnostic tissue. Transperineal biopsy has a strong infection-control advantage and is preferred in current EAU guidance; transrectal biopsy remains an established option under AUA guidance when appropriate infection precautions and experienced technique are available.
→Transperineal vs Transrectal Biopsy: Practical Comparison
| Attribute | Transperineal biopsy | Transrectal biopsy | Clinical interpretation |
|---|---|---|---|
| Needle entry | Through perineal skin. | Through rectal wall. | This is the defining distinction. |
| Ultrasound | Often uses a transrectal ultrasound probe while needle enters perineally. | Transrectal ultrasound commonly guides needle passing through rectum. | Probe location and needle route are separate concepts. |
| Clinically significant cancer detection | High with appropriate targeting and sampling. | High with appropriate targeting and sampling. | Modern randomized trials generally show comparable overall detection. |
| PREVENT GG2–5 detection | 55% | 52% | No statistically significant detection difference in the final trial. |
| PREVENT infection | 0/372 | 6/370, or 1.6% | Significant infection advantage for transperineal in this trial. |
| Rectal bacterial exposure | Avoided. | Present. | Explains much of the infection-risk difference. |
| Routine antibiotic dependence | Can often be avoided in low-risk patients under current EAU guidance. | Antimicrobial prophylaxis remains important. | Local protocols and individual risk still matter. |
| Skin / rectal preparation | Surgical disinfection of perineal skin. | Povidone-iodine rectal cleansing plus prophylaxis under EAU guidance. | Both require controlled infection-prevention protocols. |
| Anterior prostate access | Direct and flexible trajectory. | Can reach anterior targets but geometry is different. | May influence route choice for selected anterior lesions. |
| Posterior prostate access | Readily accessible with appropriate trajectory. | Natural short route from rectum to posterior gland. | Both can sample posterior lesions. |
| MRI targeting | Yes. | Yes. | Either route can use cognitive or software fusion targeting. |
| Systematic sampling | Yes. | Yes. | Route does not determine sampling strategy. |
| Local anesthesia | Yes. | Yes. | General anesthesia is not inherently required for either route. |
| Rectal bleeding | Not expected from the needle route itself. | Can occur because rectal wall is punctured. | Usually minor but heavy bleeding requires assessment. |
| Perineal bruising | Can occur. | Not typical. | Minor local bruising may follow skin puncture. |
| Urinary retention | Possible. | Possible. | Influenced by prostate size, baseline obstruction and extent of sampling. |
| EAU position | Preferred. | Alternative when appropriately performed. | Preference driven mainly by infection and antibiotic stewardship. |
| AUA position | Acceptable. | Acceptable. | AUA allows either biopsy route. |
?Common Questions About Transperineal vs Transrectal Biopsy
| Question | Practical answer |
|---|---|
| What is transperineal prostate biopsy? | A prostate biopsy in which the sampling needle passes through the perineal skin. |
| What is transrectal prostate biopsy? | A prostate biopsy in which the needle passes through the rectal wall into the prostate. |
| Which route is safer from infection? | Current overall evidence favors transperineal biopsy because it avoids direct exposure to rectal bacteria. |
| Does transperineal biopsy completely eliminate infection? | No. The risk is low but not literally zero across all patients and settings. |
| What was the PREVENT infection rate? | The final trial reported 0 infections in 372 transperineal biopsies and 6 infections, or 1.6%, in 370 transrectal biopsies. |
| Did ProBE-PC show the same difference? | No. Its broader 30-day composite infectious endpoint was 2.7% after transperineal versus 2.6% after transrectal biopsy, with no sepsis in either arm. |
| Which biopsy finds more cancer? | Overall clinically significant cancer detection is broadly similar in modern randomized comparisons. |
| What were the PREVENT detection rates? | Grade Group 2–5 cancer was detected in 55% of transperineal and 52% of transrectal patients. |
| Is transperineal better for anterior tumors? | It provides convenient anterior access, and some randomized evidence has shown greater anterior-tumor detection with the transperineal route. |
| Can transrectal biopsy reach anterior lesions? | Yes. MRI-guided planning and experienced needle placement can reach anterior lesions through the transrectal route. |
| Can transperineal biopsy sample posterior lesions? | Yes. |
| Can both methods use MRI fusion? | Yes. MRI-ultrasound fusion describes targeting technology, not the needle-entry route. |
| Is transperineal biopsy always MRI-targeted? | No. It can be targeted, systematic, template-based or a combination. |
| Is transrectal biopsy always systematic? | No. It can be MRI-targeted or fusion-guided. |
| Does transperineal biopsy require general anesthesia? | No. Modern transperineal biopsy can commonly be performed under local anesthesia. |
| Which route hurts more? | Neither is uniformly more painful when appropriate local anesthesia is used; experience varies according to technique and patient factors. |
| Does transperineal biopsy need antibiotics? | EAU guidance allows prophylaxis to be omitted in selected patients without significant infectious risk factors. |
| Does transrectal biopsy need antibiotics? | Antimicrobial prophylaxis remains an important part of current transrectal biopsy infection prevention. |
| Why is povidone-iodine used before transrectal biopsy? | Rectal cleansing reduces bacterial burden and lowers infectious complications when combined with appropriate prophylaxis. |
| Which method causes more rectal bleeding? | Rectal bleeding is more relevant to transrectal biopsy because the needle punctures the rectal wall. |
| Can transperineal biopsy cause blood in urine? | Yes. Hematuria can occur after either route because prostate tissue itself is sampled. |
| Can both cause blood in semen? | Yes. Hematospermia is common after prostate biopsy regardless of route. |
| Can both cause urinary retention? | Yes. Temporary swelling can obstruct urine flow after either route. |
| Does EAU recommend transperineal biopsy? | Yes. Current EAU guidance strongly recommends the transperineal approach because of lower infection risk and better antibiotic stewardship. |
| Does AUA allow transrectal biopsy? | Yes. AUA/SUO guidance states clinicians may use either a transrectal or transperineal route. |
| Why do guidelines differ? | They weigh infection evidence, antibiotic stewardship, feasibility, evidence certainty and implementation considerations differently. |
| Can someone switch routes for a repeat biopsy? | Yes. A previous transrectal biopsy does not prevent a later transperineal procedure, or vice versa. |
| Which route is best after a previous negative biopsy? | Route should be selected with MRI findings, lesion location, prior sampling pattern, infection history and local expertise in mind. |
| Which route is used for MRI-targeted biopsy? | Both can be used. |
| Does biopsy route determine Gleason score? | No. Gleason score and Grade Group are determined by pathology from the tissue obtained. |
| What matters most after the cores are taken? | Accurate site labeling, pathology processing, Gleason/Grade Group assessment and correlation with MRI and PSA risk. |
ΣKey Clinical Takeaways
- Transperineal and transrectal describe the needle-entry route.
- They do not describe whether biopsy is systematic or MRI-targeted.
- A transperineal biopsy passes through disinfected perineal skin.
- A transrectal biopsy passes through the rectal wall.
- Both can use transrectal ultrasound for imaging.
- Both can use MRI-ultrasound fusion.
- Both can target a PI-RADS lesion.
- Both can perform systematic or regional sampling.
- Overall clinically significant prostate-cancer detection is broadly comparable in current randomized evidence.
- The final PREVENT trial found Grade Group 2–5 cancer in 55% of transperineal versus 52% of transrectal patients.
- The detection difference in PREVENT was not statistically significant.
- Infection exposure is the clearest practical distinction between the two routes.
- Transperineal biopsy avoids direct passage through rectal flora.
- Current EAU evidence reviews show lower infectious complications overall with transperineal biopsy.
- EAU cites randomized evidence with 48 infections among 789 transrectal biopsies versus 22 among 807 transperineal biopsies.
- An EAU-cited systematic review reported sepsis rates around 0.1% for transperineal versus 0.9% for transrectal biopsy.
- In final PREVENT data, infection occurred in 0% of transperineal versus 1.6% of transrectal patients.
- Not every randomized trial has demonstrated a significant infection difference.
- ProBE-PC reported similar broader composite infection rates of 2.7% and 2.6%.
- Exact infection rates depend on definitions, prophylaxis and patient population.
- Current EAU guidance strongly recommends the transperineal route.
- The EAU preference is based mainly on infection prevention and antibiotic stewardship.
- AUA/SUO guidance permits either transperineal or transrectal biopsy.
- Transrectal biopsy remains a valid diagnostic method when performed with appropriate infection precautions.
- Rectal povidone-iodine cleansing and antimicrobial prophylaxis reduce transrectal infection risk.
- Antibiotics can be omitted in selected low-infection-risk transperineal patients under current EAU guidance.
- Both approaches can be performed under local anesthesia.
- Transperineal access offers convenient trajectories to anterior and apical prostate regions.
- Transrectal access offers a natural posterior trajectory.
- Either route can reach posterior or anterior MRI targets with appropriate technique.
- Some randomized evidence suggests route-specific differences according to anterior versus posterior tumor location.
- Urinary retention can occur after either route.
- Retention risk is influenced by prostate size, baseline urinary obstruction and sampling extent.
- Blood in urine and semen can occur after either route.
- Rectal bleeding is specifically associated with the transrectal path.
- Perineal bruising or puncture-site discomfort can occur after transperineal biopsy.
- Biopsy quality depends on more than route.
- MRI quality, targeting accuracy, core distribution, operator experience and pathology processing all matter.
- A negative biopsy does not completely exclude prostate cancer when MRI and PSA risk remain concerning.
- Biopsy pathology—not the route—determines Gleason score and Grade Group.
Clinical bottom line: transperineal and transrectal biopsy are two access routes to the same diagnostic endpoint: prostate tissue for pathology. Modern randomized trials show broadly similar clinically significant cancer detection, so the strongest difference is infection exposure rather than cancer detection. Transperineal biopsy avoids the rectal lumen, has a lower overall infectious risk in the broader evidence base and is strongly preferred by current EAU guidance for infection prevention and antibiotic stewardship. Transrectal biopsy remains an established option and is still permitted by AUA/SUO guidance. The appropriate route should therefore account for infection risk, MRI-target location, prostate anatomy, prior biopsy history, local expertise and the sampling strategy required to answer the clinical question.
Medical disclaimer: This article provides general medical education. The safest biopsy route for an individual depends on MRI findings, prostate anatomy, prior infection history, urinary symptoms, medications, antibiotic resistance, previous biopsy results, anesthesia needs and local expertise. Do not start or stop antibiotics, anticoagulants or antiplatelet medicines for prostate biopsy without instructions from the treating medical team.
For how prostate tissue sampling fits into the full diagnostic process, see What Is a Prostate Biopsy? and How Prostate Cancer Is Diagnosed. If biopsy is being considered because MRI found an abnormal region, review What Is a Prostate Lesion?, What Is a Prostate MRI?, Multiparametric Prostate MRI and PI-RADS Scoring. For the biochemical risk that helps determine whether biopsy is needed at all, see PSA Testing, PSA Density and What Happens After a High PSA?. For the complete cancer pathway, return to the Prostate Cancer hub. The next guide explains MRI-targeted prostate biopsy, including cognitive targeting, MRI-ultrasound fusion, in-bore biopsy and how suspicious MRI lesions are sampled.
Evidence Sources
- European Association of Urology — Prostate Cancer Diagnostic Evaluation: transperineal versus transrectal cancer detection, infection evidence, sepsis estimates, antibiotic stewardship, local anesthesia and biopsy-route recommendations.
- Hu JC, Assel M, Allaf ME, et al. Transperineal vs Transrectal Prostate Biopsy—The PREVENT Randomized Clinical Trial. JAMA Oncology. 2024;10(11):1590–1593.
- Mian BM, et al. Complications Following Transrectal and Transperineal Prostate Biopsy: Results of the ProBE-PC Randomized Clinical Trial. Journal of Urology.
- American Urological Association / Society of Urologic Oncology — Early Detection of Prostate Cancer: biopsy technique and recommendation allowing either transrectal or transperineal biopsy routes.
- National Cancer Institute — Prostate-Specific Antigen Test: diagnostic evaluation after persistent prostate-cancer suspicion and the role of prostate biopsy.
