Transepithelial puncture allows better localization of most glands and more precise multipoint puncture, and more and more hospitals are using transepithelial prostate puncture.
Specifically:
Prostate puncture is a very important and essential method for definitive diagnosis of prostate cancer and is also an invasive test, using a special puncture needle guided by ultrasound to penetrate the prostate gland to obtain thin strips of prostate tissue for pathologic examination.
There are two major ultrasound-guided trans-perineal or trans-rectal routes for prostate cancer puncture, which are different but have comparable diagnostic efficacy.
The base of the prostate is close to the rectum, so most of the early prostate punctures were performed via the rectal route, which is generally convenient and accurate and does not require anesthesia. However, preoperative bowel preparation is required, and postoperative complications of infection are relatively frequent and usually require prophylactic antibiotics.
Trans-perineal ultrasound-guided puncture, which is performed in the perineal region between the urethral root and the anus as the entry point, requires local anesthesia of the skin and is more time-consuming because the distance from the skin to the prostate is slightly longer, requiring repeated adjustments of the puncture needle during the puncture. However, with trans-perineal puncture, the puncture target and the entire puncture needle tip can be displayed and the puncture target is clear. Because it does not pass through the rectum, bowel preparation and prophylactic antibiotics may not be required.
Transepithelial puncture allows better localization of most of the prostate gland, and computerized fusion of MRI images with intraoperative ultrasound images allows for more precise multipoint puncture and precise targeting of suspicious lesions on MRI images, so more hospitals are now using transepithelial prostate puncture.