目前，前列腺活检仅依靠经直肠超声（US）进行导向。然而，无肛门男性无法进行这种活检。本研究的目的是展示经会阴超声（TPUS）导向活检技术在进行Miles手术的患者中的结果。在2009年4月至2022年3月期间，连续有9名患者（中位数71岁；范围61-78岁）进行TPUS导向活检，这些患者的前列腺特异性抗原值很高（22.60ng/mL；6.19-69.7ng/mL），他们的肛门都因直肠癌而切除。根据前列腺核磁共振成像，进行TPUS导向活检。记录技术成功率、癌症检测率和并发症率。使用Welch校正的未配对t检验比较良性组和癌症组的肿瘤大小。所有患者均成功进行了新的TPUS导向活检。检测到7名患者的癌症，检出率为77.8%（9/7）。它们都被归类为PI-RADS 5。其中，显著癌症（Gleason评分为7或更高）的检出率为66.7%（6/9）。肿瘤大小的中位数为2.4cm（1.7-3.1cm）。但是，有两名患者被诊断为PI-RADS3或PI-RADS4的良性组织。他们的中位数肿瘤大小为1.0cm（0.8-1.2cm）。在肿瘤大小方面，癌症组和良性组之间存在显著差异（p = 0.037）。术后未出现出血或感染。新的TPUS导向活检技术可以有助于在Miles手术后男性中检测到较大的PI-RADS 5前列腺癌。©2023.作者（们）。

Currently, a prostate biopsy is guided by transrectal ultrasound (US) alone. However, this biopsy cannot be performed in men without an anus. The aim of this study was to show the outcomes of a new transperineal US (TPUS)-guided biopsy technique in patients who underwent Miles' operation.Between April 2009 and March 2022, TPUS-guided biopsy was consecutively conducted in 9 patients (median, 71 years; range, 61-78 years) with high prostate-specific antigen values (22.60 ng/mL; 6.19-69.7 ng/mL). Their anuses were all removed due to rectal cancer. TPUS-guided biopsy was performed according to information on prostate magnetic resonance imaging. The technical success rate, cancer detection rate, and complication rate were recorded. Tumor sizes were compared between benign and cancer groups using an unpaired t-test with Welch's correction.The new TPUS-guided biopsy was successfully performed in all patients. Cancer was detected in 77.8% (7/9) of the patients. These were all categorized as PI-RADS 5. Among them, the detection rate of significant cancer (Gleason score 7 or higher) was 66.7% (6/9). The median tumor size was 2.4 cm (1.7-3.1 cm). However, two patients were diagnosed with benign tissue with PI-RADS 3 or PI-RADS 4. Their median tumor size was 1.0 cm (0.8-1.2 cm). There was significant difference between the cancer and benign groups (p = 0.037) in terms of tumor size. Neither post-biopsy bleeding nor infections occurred.New TPUS-guided biopsy technique may contribute to detecting large PI-RADS 5 prostate cancer in men after Miles' operation.© 2023. The Author(s).