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Urologists at UNC are at the forefront of performing a highly effective procedure called “transperineal biopsies” of the prostate, in which the biopsy needle enters through the patient’s perineum instead of the rectum. At UNC, traditional transrectal biopsies have a very low risk of serious infection.

The transperineal biopsy approach may further reduce the potential for bacteria being unintentionally transferred to the prostate and causing an infection, and it does not require preparatory use of an enema or antibiotics.

“The newer approach of using transperineal biopsies require less advanced prep for the patient, has lower risk of infections and bleeding, and allow us to better and more efficiently sample the prostate, especially historically less accessible areas such as the anterior prostate,” says Marc Bjurlin, DO, Associate Professor of Urology at UNC.

Offering the Latest Techniques to Patients

Dr. Bjurlin spearheaded the effort to bring the procedure to UNC, where its use is steadily increasing. While the procedure has been more commonly practiced in Europe, it has been more recently adopted for use in the U.S. by some leading academic medical centers.

“In some cases it can make it easier to detect cancer in some areas of the prostate, and it allows us to make only two entry locations, vs. multiple needed for other procedures. This is a distinct benefit for patients,” says Dr. Bjurlin.

“I was very passionate about bringing this innovative procedure to UNC because it provides a more efficient and potentially safer way to biopsy patients’ prostates.”

Marc Bjurlin, DO, MSc, FACOS
Director of Clinical Trials
Associate Professor of Urology

Marc Bjurlin, DO, MSc,


He adds that transperineal biopsies are also particularly helpful for men who have undergone repeated transrectal biopsies where anterior tumors may have been missed.

Dr. Ray Tan, Director of Urologic Oncology and Associate Professor of Urology at UNC, adds that the procedure has additional benefits for some patients. “We are really excited to add transperineal biopsies as an option for our patients,” he says. “For some patients, like those with previous negative transrectal biopsies or previous infections, this new approach can make a world of difference.”

Both transperineal and the more common rectal biopsies of the prostate are considered highly effective, are routinely performed under local anesthesia, and both are generally well tolerated by patients. Both can also be combined with the MRI-ultrasound fusion approach to further improve diagnostic performance.

UNC is one of the leading academic centers offering transperineal biopsies, and is adding capacity to perform the procedure in a larger number of patients in the future.

If you or a loved one are interested in learning more about these procedures or related urologic topics, you may visit our website’s Patient Care section, or meet with a provider by contacting one of our UNC Urology clinic locations.

About Our Ahead of the Curve Series

Our “Ahead of the Curve” blog series covers the latest and most effective treatments and techniques in UNC Urology patient care. Urology is a complex and rapidly evolving field, with new advancements and breakthroughs constantly emerging. In this series, we will explore a range of topics related to urology patient care, including advanced surgical procedures, innovative diagnostic techniques, and innovative medical therapies. Our goal is to provide you with an overview of the excellence and innovation happening right here at UNC Urology.

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