OBJECTIVETo compare the detection rates of prostate cancer (PCa) and complications of the transrectal ultrasonography (TRUS)-guided 24-core saturation scheme versus 14-core scheme for transperineal prostate biopsy in patients with total PSA < 20 microg/L.

METHODSWe performed TRUS-guided 24-core saturation transperineal biopsy for 136 patients suspected of PCa (24-core group) and 14-core biopsy for another 116 (14-core group). We compared the PCa detection rates and post-biopsy complications, such as gross hematuria, urinary system infection, and acute urinary retention between the two groups.

RESULTSThe baseline characteristics of the two groups were comparable with regard to the mean age, prostate volume and PSA level (P>0.05). The positive rates of PCa detection were 48.53% (66/136) in the 24-core group and 17.24% (20/116) in the 14-core group (P<0.001), and the positive rates of samples were 8.09% and 2.83%, respectively (P=0.012). The detection rate of PCa in the apex zone was significantly higher in the former (11.76%) than in the latter (1.72%) (P<0.05). There were no statistically significant differences in such post-biopsy complications as gross hematuria, urinary system infection, and acute urinary retention between the two groups (P>0.05).

CONCLUSIONTRUS-guided 24-core saturation transperineal biopsy of the prostate is superior to the 14-core scheme for its higher detection rate of PCa, particularly PCa in the apex zone, and lower incidence of complications in patients with PSA < 20 microg/L.