There are indications for biopsy of the prostate when formal perineal exposure is not desirable, necessary, nor, on occasion, possible. The purpose of this report is to present a simple method for securing adequate prostatic tissue for biopsy. This technique was first used by one of us (J. L. E.) in 1947. The procedure has recently been followed in over 50 cases, without complications of any type; there have been no fistulas. We are unable to find reference to this technique in the literature.
In this procedure saddle block anesthesia is preferable because of the degree of anal relaxation required. Biopsy tissue is secured with the patient in a modified jackknife position. The instrument utilized is the Fansler operating rectal speculum (see figure). The wide caliber of the instrument permits ready palpation of the prostate and manipulation of the biopsy forceps through the lumen. Attempts to use simple anal
Grabstald H, Elliott JL. TRANSRECTAL BIOPSY OF THE PROSTATE. JAMA. 1953;153(6):563–565. doi:10.1001/jama.1953.02940230035006k