Transperineal biopsies detect more prostate cancers, cause discomfort

A large study in the UK has found that transperineal prostate biopsies are more effective at detecting significant cancers compared to the traditional transrectal method. This study, called TRANSLATE, involved over 1,100 patients and showed that the transperineal approach identified 5.7% more clinically significant prostate cancers. Richard Bryant, a leading researcher in the study, pointed out that earlier studies mostly focused on infection rates rather than cancer detection. He emphasized that finding clinically significant cancer is the main goal of the biopsy, although minimizing infection is also important. The results were shared at the 2025 European Association of Urology congress and published in The Lancet Oncology. While the study focused on cancer detection, it also noted that men reported more pain and discomfort after transperineal biopsies compared to transrectal ones. Hospitalization rates after biopsies indicated a slight advantage for the transperineal method. Only two men needed hospitalization after transperineal biopsies, compared to nine after transrectal biopsies, although this difference was not strongly significant. Experts in the field acknowledge the lower rate of infection as a clear advantage of the transperineal approach. Nearly 90% of men who underwent transperineal biopsies did not need antibiotics, which is seen as a positive aspect, especially in Europe where antibiotic use is carefully monitored. Some researchers are calling for a balanced view of both biopsy methods. They stress that both techniques can be safe and effective while recognizing the pros and cons each offers. The TRANSLATE study was funded by the UK's National Institute for Health and Care Research, and Richard Bryant received training support for his research.