Dr. Moran has developed Stereotactic Transperineal Prostate Biopsy (STPB). This is the most comprehensive, sophisticated prostate biopsy technique available, diagnosing 40% more cancer than the standard office procedure — cancer that would have otherwise gone undetected.
Many of the cancers missed by the standard transrectal biopsy are in the apex of the prostate gland. The apex of the prostate gland is located at the bottom of the gland. The apex is pointed down to the perineum as opposed to the base which is wider and located next to the bladder.
Stereotactic Transperineal Prostate Biopsy has many advantages, the first of which is its increased ability to identify occult or “hiding cancers”. Our research and the research of others have clearly demonstrated that the transrectal biopsy does miss a significant percentage of cancers that occur in the anterior or front portion of the prostate. Our data in over 2,200 patients suggests that as high as 40% of patients are thought not to have malignancy, but indeed do have malignancy. Dr. Moran has previously published this information in Urology and the Journal of Urology.
The second advantage to having a prostate biopsy using the perineal approach is that the infection rate is almost 0%. This is simply because the rectal wall or rectum in general is not penetrated by the biopsy needle. Infection is common after transrectal prostate biopsy, but STPB significantly decreases your risk for infection.
STPB is performed by comprehensively sampling the prostate through the perineum while the patient is under general anesthesia. Performed as an outpatient procedure, it allows more comprehensive sampling, compared to the transrectal method, which takes fewer samples through the rectum. Unlike random sampling with transrectal prostate biopsy, with our extensive template-guided approach, we can identify exactly where the positive and negative specimens were retrieved. This allows for more sophisticated treatment plans for those with positive biopsies, and relief for those patients whose biopsies were negative.
Overall benefits of STPB include:
- Diagnosing 40% more cancer
- One-time, out-patient procedure (no hospital stay needed)
- Minimally invasive (no incisions or stitches)
- Performed under general anesthesia with no discomfort
- Infection rate negligible
- Confidence in exact location of cancer
- Minimal, if any, post-operative pain
- Return to normal activity within a day