Introduction: Transperineal prostate biopsy (TP-Bx) is favored due to reduced infection risk, yet the degree to which TP-Bx is taught to urology trainees is unclear. We used distributed a survey in the United States and Europe assess urology trainees’ exposure to TP-Bx and intent to use TP-Bx in practice. Methods: A 34-question survey about prostate biopsy was distributed to urology trainees in the United States (US) and Europe. Primary outcomes were exposure to TP-Bx in training and intent to use TP-Bx post-training. Exposure to transrectal prostate biopsy (TR-Bx) and magnetic resonance imaging-targeted biopsy (MRI-Bx) was also assessed. Survey answers between groups were compared as categorical variables using Fisher’s exact test. Multivariable logistic regression was used to identify factors associated with intent of performing TP-Bx post-training. Results: Six hundred fifty-eight trainees from 19 countries completed the survey. Three hundred and thirteen (48%) trainees reported exposure to TP-Bx, 370 (56%) reported exposure to MRI-Bx, and 572 (87%) reported exposure to TR-Bx. There was significant heterogeneity in TP-Bx exposure among countries (p < 0.001), with highest prevalence in Italy (72%) and lowest prevalence in Greece (4%). Intent to perform TP-Bx post-training was higher in those exposed to TP-Bx during training (89% vs. 58%, p<0.001) and did not differ between trainees in post-graduate year (PGY) 1-3 vs. PGY =4 (73% vs 72%, p=0.7). On multivariable regression, exposure to TP-Bx in training was independently associated with increased intent to perform TP-Bx post-training (odds ratio: 5.09, 95% confidence interval: 3.29 – 8.03, p<0.001). Conclusions: Less than half of 658 surveyed urology trainees reported exposure to TP-Bx, with significant heterogeneity between countries. Greater experience with TP-Bx in training was associated with greater intent to perform TP-Bx post-training. A minimum requirement of TP-Bx cases during urological training may increase resident familiarity and adoption of this guideline-endorsed prostate biopsy approach. SOURCE OF Funding: n/a
