Prostate Biopsy Melbourne
A transperineal prostate biopsy is a diagnostic procedure used to detect prostate cancer by obtaining tissue samples from the prostate gland. This method involves inserting a needle through the perineum (the skin between the scrotum and anus) under ultrasound and/or MRI guidance, offering improved accuracy and significantly lower infection risk compared to the traditional transrectal approach.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Significantly lower risk of serious infection (virtually zero sepsis risk)
- No need for antibiotics in most protocols
- Improved accuracy with access to all prostate zones including anterior
- MRI-fusion capability for targeted sampling of suspicious lesions
- Better sampling of the anterior prostate often missed by transrectal approach
- Can be performed under local anaesthesia
- Suitable for patients on blood thinners with appropriate management
- Ideal for repeat biopsies when prior transrectal biopsy was negative
The Procedure
The transperineal prostate biopsy is performed with the patient lying on their back with legs supported. Dr Dias uses a free-hand transperineal prostate biopsy technique under ultrasound guidance using PRECISION POINT™ or PIVOT PRO™ devices, providing accurate prostate sampling and minimal discomfort thereby enabling the procedure to be performed safely under local anaesthesia or mild sedation. If MRI-fusion is used, pre-biopsy MRI images are overlaid to precisely target suspicious areas. A needle is then passed through the skin of the perineum into the prostate under ultrasound guidance, and multiple tissue cores (typically 12-24) are obtained from different regions. The samples are sent for pathological examination to detect and grade any cancer present.
Who Is a Candidate?
Transperineal biopsy is recommended for men with elevated PSA levels, abnormal digital rectal examination, or suspicious findings on MRI. It is particularly indicated for patients with prior negative transrectal biopsies who remain at risk for prostate cancer, those with MRI-visible lesions requiring targeted sampling, men at higher risk of infection, and those on anticoagulation therapy. Dr Dias uses a free-hand ultrasound-guided technique with PRECISION POINT™ or PIVOT PRO™ devices, allowing the procedure to be performed safely under local anaesthesia or mild sedation. Dr Dias will review your PSA history, MRI findings, and risk factors to determine if biopsy is appropriate.
Recovery
Most patients experience mild discomfort in the perineal area for 1-2 days after the procedure. Blood in the urine and semen is common and may persist for several weeks—this is normal and not a cause for concern. Most patients can return to normal activities within 24-48 hours. Results are typically available within 1-2 weeks, at which point Dr Dias will discuss findings and any further treatment recommendations.
Risks & Considerations
Transperineal biopsy has an excellent safety profile. The risk of serious infection requiring hospitalisation is less than 0.1%, compared to 2-4% with the transrectal approach. Other potential risks include bruising and discomfort at the biopsy site, blood in urine and semen (common and temporary), urinary retention (rare), and erectile dysfunction (very rare and usually temporary). The procedure may miss some cancers, which is why MRI-fusion targeting and systematic sampling are used to maximise detection accuracy.