What is a perineal biopsy of the prostate?

A perineal biopsy of the prostate consists of taking several small fragments of the prostate tissue through the perineal skin. This is the region between the anus and the scrotum (we speak of the trans-perineal route).
The new technique is expanding in North America since the infection rate is almost zero, contrary to transrectal biopsy. Infection rates after transrectal biopsy are increasing as a result of increased resistance to antibiotics. Also, there is a low risk of sepsis (severe infection) requiring hospitalization in the intensive care unit.

Perineal biopsies are rather sterile without passing through the rectum.

It is done by 2 sites of skin samples, one site per right and left prostate side instead of 12 to 14 transrectal sites.
The fever secondary to bacteremia is almost non-existent.

This sampling is done with a special needle on each side of the space above the rectum. The doctor is guided by a transrectal ultrasound probe which allows him to clearly visualize the place where he will take his sample.

A biopsy may be indicated when an abnormality has been detected by a digital rectal examination when the value of PSA is high for the age of the man, or it increases with the time. This is the easiest way to remove prostate fragments without surgery.