Positive Margin Location and Prostate Biopsy Route: A Consecutive Cohort Comparison of Transperineal and Transrectal Techniques

Abstract

Background: Transperineal (TP) prostate biopsy is increasingly used due to its superior infectious safety and enhanced sampling of anterior and apical prostate regions. Concerns have been raised that TP biopsy may induce greater post-biopsy fibrosis, particularly at the apex, potentially increasing positive surgical margin (PSM) rates at radical prostatectomy (RP). We evaluated whether biopsy technique influences overall or location-specific PSMs at RP. Methods: We performed a retrospective comparative cohort study of 1027 consecutive men who underwent TR biopsy and TP biopsy at our institution as we transitioned from TR to TP diagnostic technique. Patients from this cohort who were subseque..