title: Transperineal versus transrectal prostate biopsy: our findings in a tertiary health institution.
abstract: OBJECTIVE
  Prostate cancer is a major public health issue. Its incidence is rising, especially in Nigeria. Prompt diagnosis is necessary by histology. Transperineal and transrectal approaches to prostate biopsy are well-documented. Both methods are fraught with complications though, most times minor. Studies carried out to compare both methods were carried out mainly on Caucasians, generating conflicting results. This study aims to compare the complication rates and tissue yield of these two methods in Nigerian men.
  
  
  METHODS
  Seventy-five patients completed the study. Forty-five patients had transperineal prostate biopsy (TPbx), while 30 patients had transrectal prostate biopsy. Pain perception for all patients was determined by visual analog scale; whereas the complications were ascertained by a validated purpose designed questionnaire administered on the 7 th and 30 th day post operatively.
  
  
  RESULTS
  The risk of rectal bleeding was higher for transrectal prostate biopsy compared to transperineal (Odds ratio: 0.03; 95% confidence interval (CI): 0.001-0.450; P = 0.012). TPbx was more painful than transrectal (P < 0.0001; df: 75; t: 4.98; 95%CI of difference in mean: -2.98-[-1.28]). There was no statistical difference between transperineal and transrectal prostate biopsy in hemospermia, fever, prostatic abscess, urethral bleeding, acute retention and tissue yield.
  
  
  CONCLUSIONS
  TPbx is more painful than transrectal prostate biopsy though with a significantly reduced risk of rectal bleeding. There appears to be no significant difference with respect to risk of fever, urethral bleeding, hematospermia, prostatic abscess and acute retention. Both routes provided sufficient prostate tissue for histology.
authors.affiliation: Department of Surgery, ESUT Teaching Hospital, Parklane, Enugu, Nigeria.
authors.forename: E I
authors.initials: EI
authors.lastname: Udeh
authors.forename: O C
authors.initials: OC
authors.lastname: Amu
authors.forename: I I
authors.initials: II
authors.lastname: Nnabugwu
authors.forename: Ofn
authors.initials: O
authors.lastname: Ozoemena
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D005334:Fever / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010502:Perineum; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000473:pathology*; D012007:Rectum; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
chemical_list: D017430:Prostate-Specific Antigen