Objective:

To provide instructional guidance on performing a device-free, free-handed transperineal prostate biopsy for urologic oncologists.

Key Findings:

• Lower risk of post-biopsy sepsis and rectal bleeding compared to transrectal biopsies, supported by recent studies.
• Potentially more effective cancer detection rates, as indicated by comparative research.
• Cost savings by eliminating the need for ultrasound needle mounts, reducing overall procedure costs.

Interpretation:

The device-free, free-handed transperineal approach offers significant advantages in safety, cost, and effectiveness for prostate biopsies, potentially improving patient outcomes.

Limitations:

• Optimal biopsy template consensus not established, which may affect standardization.
• Requires skilled clinicians for effective execution, highlighting the need for proper training.

Conclusion:

The free-handed transperineal prostate biopsy can be performed safely and effectively in an office setting, providing substantial benefits over traditional methods, emphasizing the importance of clinician training.