MRI-fusion transperineal prostate biopsy – The solution in prostate cancer detection

Last updated: April 29, 2026

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Today, we will dive deep into the new procedure which been called the “MRI-fusion transperineal prostate biopsy”. Prostate cancer is the second most common solid tumor occur among gentleman worldwide. In the past, for suspecting prostate cancer a patient was needs to do the biopsy procedure called the “Transrectal random prostate biopsy” at that time the quality of that procedure which is less in accuracy and easily to get infected from the feces that contaminated during the biopsy that needle punched through the rectal wall for reaching the prostate tissue.

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This is the reason that the new technique is being invented. This new technique took advantage and virtually assisted of an MRI technology which can mapping the gland in advance for the possibility in guiding the urologist to foresee the prostate gland that could be the suspected for the cancer. The MRI-fusion instrument – its name makes urologists feel firmly confident when getting the biopsy because we can real-time synchronize MRI prostate data with ultrasound probe during the biopsy procedure. Another benefit is, the Transperineal technique making the biopsy needle tract pass through the perineal skin directly to the prostate gland which no need to pass through the rectal wall like old approach anymore.

To get it easy understand, I will do a comparison as below;

Comparison between each prostate biopsy technique

	MRI-fusion transperineal approach	Conventional transrectal approach
Needle approach	Through the perineal skin	Through the rectal wall
MRI-guidance	Guidance	No Guidance
Cancer detection rate	81%	40%
Blood stream infection	0.4 – 1.1%	2.0 – 9.1%
Bloody urination	48.8%	66.3%
Rectal bleeding	3.5%	18.1%
Pain	4.2%	4.5%
Urinary retention	1.1%	2.3%
Prostatitis	0%	0.6%

As you can notice that the new MRI-fusion transperineal prostate biopsy can maximize the detection rate up to 81% – which means a lot of value for the patient to make decision for doing the biopsy procedure and also getting less in post procedure complications.

Any question on this prostate biopsy technique, please talk to your trusted urologist or it would be my pleasure if you text me.

Dr. Soarawee was invited as an international speaker at the Taiwan Urology Association (TUOA2020) to present on prostate cancer management. Learn more about his clinical leadership and global impact.

You can visit my official homepage here.

Frequently Asked Questions

Q1: What is MRI-fusion transperineal prostate biopsy?

MRI-fusion transperineal prostate biopsy is an advanced prostate cancer detection technique that combines real-time MRI data with ultrasound guidance. The biopsy needle is inserted through the perineal skin rather than the rectal wall, significantly reducing infection risk while improving cancer detection accuracy to up to 81% compared to 40% with the conventional transrectal approach.

Q2: Why is the transperineal approach safer than the transrectal approach?

The transperineal approach avoids passing the biopsy needle through the rectal wall, which eliminates contamination from fecal bacteria. This dramatically reduces the risk of bloodstream infection from 2.0-9.1% with the conventional transrectal method down to just 0.4-1.1% with the transperineal technique. It also results in significantly less rectal bleeding.

Q3: Who should consider MRI-fusion transperineal prostate biopsy?

Men with elevated PSA levels, abnormal digital rectal examination findings, or suspicious MRI prostate results should consider this procedure. It is particularly beneficial for men who have had a previous negative biopsy but remain clinically suspicious for prostate cancer, as the MRI guidance allows targeted sampling of suspicious lesions.

Q4: Is MRI-fusion transperineal prostate biopsy available in Bangkok?

Yes. Dr. Soarawee Weerasopone performs MRI-fusion transperineal prostate biopsy at Bangkok Hospital Headquarters. As a urologist with specialized training in prostate cancer management and international surgical fellowships, Dr. Soarawee offers this state-of-the-art diagnostic procedure to both Thai and international patients.

Q5: What should I expect after MRI-fusion transperineal prostate biopsy?

After the procedure, you may experience mild bloody urination (in approximately 48.8% of patients) and minor perineal discomfort, both of which typically resolve within a few days. The risk of serious complications such as infection or urinary retention is very low with the transperineal technique. Your urologist will provide specific post-procedure instructions and follow-up arrangements.

If you have concerns about prostate cancer or would like to discuss the MRI-fusion transperineal biopsy procedure, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Book a Consultation.

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.