Huang GL, et al. - A total of 238 outpatient visits meeting the criteria for prostate cancer biopsy were recruited for this study in order to contrast the cancer detection rates between transrectal (TR) and transperineal (TP) approaches, evaluate the postbioptic complications of the two procedures, and assess feasibility of performing TP biopsies under local anesthesia. Between TP and TR groups, the cancer detection rates were quite similar. Nevertheless, in comparison with the TR group, the TP group had a significantly lower incidence of infection-related complications (except epididymitis and prostatitis) that generally happen following biopsies. None of the persons in the TP group were hospitalized because of the postbioptic complications, while a minor portion of those in the TR group needing hospitalization following biopsy was still present. For the TP and TR procedures under local anesthesia, medians (25–75% quartiles) of visual analog scale were 3 [3, 4] and 4 [3–5] respectively, however, no statistical importance was there between them. In conclusion, individuals receiving TP biopsy are less inclined to show infection-related complications. Hence, for prostate cancer identification, TP biopsy is a more feasible local anesthetic strategy if there are concerns for infectious complications and/or the risk of general anesthesia.