Prostate biopsy via the perineum with local anesthetic and MRI targeting is feasible, tolerable and can be performed in ambulatory settings, according to a British study published online May 9 in Prostate Cancer and Prostatic Diseases.

This approach is sufficiently more comfortable than the usual transrectal route to the target that more than 90 percent of patients in the study said they would recommend it to other men, the authors report.

Edward Bass of University College London and colleagues evaluated transperineal MRI-targeted prostate biopsy as performed on 181 consecutive patients who received a local and anesthetic and had a total of 243 prostate lesions.

Just one procedure was halted due to patient discomfort, and there were no episodes of sepsis or re-admissions.

As for findings, cancer was detected in 142 of the 181 (78 percent). Significant disease was more likely in higher MRI-scoring lesions, the authors found.  

“Despite high rates of disease misclassification and sepsis, the use of transrectal biopsy remains commonplace,” they write. “Transperineal mapping biopsies mitigate these problems but carry increased cost and patient burden. Local anesthetic, multiparametric MRI-targeted transperineal biopsy may offer an alternative.”