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OBJECTIVE To evaluate the clinical and financial implications of a decade of prostate biopsies in the United Kingdom National health Service (NHS) through the transrectal (TR) and transperineal (TP) route. In the current antibiotic resistant era, TR biopsies of the prostate have alarmingly high infectious complications and readmissions. The TP route is a credible step to minimise these events, however the data comparing the two approaches has not been consolidated. METHODS This is an evaluation of TR versus TP biopsy approach in the co