Introduction: Transperineal prostate (TP) biopsy has emerged as a substantial alternative to the conventional transrectal (TR) approach for prostate sampling by its ability to sample specific areas of the prostate more effectively. The objective of this review is to conduct a comparative analysis of the current literature regarding diagnostic accuracy, complication rate and clinical outcome of transrectal vs. transperineal approaches in prostate biopsy-naïve patients and in repeated biopsy scenarios. Materials and Methods: An extensive search of the literature in PubMed, Scopus, and Web of Science was conducted between September 2010 and September 2024. We utilized a robust and comprehensive retrieval strategy including phrasing the two approaches as follows: (perineal or transperineal) and (rectal or transrectal). Conclusions: The transperineal and transrectal approaches show similar results in the detection of PCa in biopsy-naïve men, similar rates of infection, urinary retention and effectiveness managing biopsy-associated pain. However, in the rebiopsy scenario, the TP approach has demonstrated increased accuracy compared to the TR approach. This has significant implications in decision making and patient counselling.
引言：经会阴前列腺穿刺活检（TP）因其能更有效地对前列腺特定区域进行取样，已成为传统经直肠（TR）穿刺方法的重要替代方案。本综述旨在对当前文献中关于初次接受前列腺活检患者及重复活检情况下，经直肠与经会阴两种穿刺方法在诊断准确性、并发症发生率及临床结局方面进行对比分析。材料与方法：我们在2010年9月至2024年9月期间对PubMed、Scopus和Web of Science数据库进行了系统性文献检索，采用全面严谨的检索策略，将两种穿刺方法表述为：（会阴或经会阴）与（直肠或经直肠）。结论：在初次接受活检的男性患者中，经会阴与经直肠穿刺方法在前列腺癌检出率、感染发生率、尿潴留发生率及活检相关疼痛管理效果方面表现相似。然而在重复活检情况下，经会阴穿刺法较经直肠穿刺法展现出更高的诊断准确性，这一发现对临床决策制定和患者咨询具有重要指导意义。
肿瘤(癌症)患者之家