Freehand Ultrasound-Guided Transperineal Prostate Biopsy: Technique and Early Results

Abstract

Abstract Introduction: Approximately 1 million prostate biopsies are performed yearly, the vast majority of which are performed transrectally.1 Passing biopsy needles through the rectal wall introduces bacteria into the prostate parenchyma.2 The resistance of coliform bacteria to fluoroquinolone antibiotics is as high as 22%,2,3 and the infectious complications have increased to as high as 7% with hospitalization risk as high as 4%.4 I demonstrate a technique avoiding this infectious risk by passing the biopsy needle through the perineum using a freehand technique under ultrasound monitoring. Materials and Methods: All procedures were performed in the Ambulatory Urology Surgical Center (Cumberland, MD) by one urologist. Patients requiring prostate biopsy, in accordance with accepted standards of urologic care, were offered the option of sedation and/or local anesthesia. Patients did not receive bowel preparation, prior rectal swab, or pre-/postoperative antibiotics. Intravenous access was obtained for a w...