Abstract: Objective To compare the diagnostic efficacy and safety of transperineal prostate biopsy (TPPB) and transrectal prostate biopsy (TRPB) in prostate cancer. Methods From January 2018 to January 2020, 237 patients received prostate biopsy under local anaesthesia in Beijing Chaoyang Hosipital, Capital Medical University, including TRPB applied to 185 patients between January 2018 and June 2019 and TPPB to 52 cases between July 2019 and January 2020. Results The perioperative information was analyzed and compared. There was no statistically significant differences between the two groups in preoperative parameters, including age [(68.2±9.2) years vs (69.7±8.1) years, P=0.331], body mass index (BMI) [(24.7±3.3) kg/m² vs (24.7±3.1) kg/m², P=0.924], Charlson comorbidity index (CCI) (2.7±1.7 vs 2.8±1.1, P=0.744), prostate volume [(59.5±32.0) cm³ vs (65.9±28.7) cm³, P=0.512)], and International Prostate Symptom Score (IPSS) (10.3±4.7 vs 10.2±5.0, P=0.960). No significant differences was found between the two groups in preoperative laboratory results (P>0.05).Fifty-two patients of TPPB and 185 patients of TRPB was successfully implemented, with 33and 145 cases of complications in Grade 1 of Clavien-Dindo in postoperative 7 days. There were no statistically significant differences between the two groups in cores, positive cores, pathology positive, Gleason Score, clinically significant prostate cancer (CsPCa), hematuria, lower urinary tract symptoms (LUTs), hematospermia or other Clavien-Dindo1 complications. The TPPB group acquired more operative time (P<0.001), less bleeding at puncture points (P=0.003), fewer fever (P=0.047), and more cases of Visual Analogue Scale/Score(VAS)≥4(P=0.005) with statistical significance. Conclusion Compared with TRPB, TPPB possesses similar diagnostic efficacy under local anaesthesia or general anesthesia if needed, with decreased bleeding at puncture points and the rate of fever.

Key words: prostate biopsy, perineal, rectum