Guilherme Godoy, MD, MS, presented “Through the Perineum or Through the Rectum: How to Best Biopsy the Prostate” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.

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How to cite: Godoy, Guilherme. Through the Perineum or Through the Rectum: How to Best Biopsy the Prostate.” September 22, 2024. Accessed Nov 2024 . https://grandroundsinurology.com/through-the-perineum-or-through-the-rectum-how-to-best-biopsy-the-prostate/

Through the Perineum or Through the Rectum: How to Best Biopsy the Prostate – Summary

Guilherme Godoy, MD, MS, addresses prostate biopsy techniques, contrasting transrectal and transperineal approaches. 

In this 20-minute presentation, Dr. Godoy highlights the current debate between transrectal and transperineal approaches. Transrectal biopsy remains a familiar, office-based procedure requiring only local anesthesia, offering easy access and minimal patient discomfort. However, it poses infection risks. Conversely, the transperineal approach minimizes infection risk. This approach, however, is often more painful, typically requires sedation, and may incur higher equipment and procedural costs, as well as a longer learning curve for practitioners. Godoy also discusses recent studies comparing the effectiveness of these techniques. Research indicates no significant difference in cancer detection rates between transrectal and transperineal biopsies. 

The integration of MRI-ultrasound fusion and cognitive fusion biopsy techniques continues to enhance the precision of both approaches, especially in targeting smaller, more localized prostate lesions. Godoy feels biopsy methods may evolve further as MRI technology improves, potentially eliminating the need for whole-prostate sampling. Instead, biopsies could focus more on specific, MRI-identified lesions, reducing patient discomfort and procedural risks while improving diagnostic accuracy.

 

About The 28th Annual Innovations in Urologic Practice:

Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.

For further educational activities from this conference, visit our collection page.