Chiari R, Harzmann R
Urologe A. 1975 Nov;14(6):296-8.
On 254 biopsies of the prostate with the tru-cut needle the approach was either rectal or perineal depending on even or uneven dates of birth. The rectal approach showed wrong negative results a little more frequent than the perineal approach. Feverish complications were 6 times more often by rectal than by perineal approach. Additionally the rectal biopsy was complicated by serious bleedings out of the hemorrhoidal vessels or periprostatic veins. Based on the investigations you should chose the perineal approach as the routine method and use the rectal biopsy only for special indication.