Subcutaneous hematoma of the lower abdomen and perineum following transperineal prostate biopsy: a case report and literature review

Prostate cancer (PCa) is the most common malignant neoplasm of the urogenital system, with definitive diagnosis currently relying exclusively on prostate biopsy. Although the transperineal approach is associated with a lower incidence of perioperative complications, postoperative subcutaneous hematoma in the perineal region may be overlooked due to its anatomically concealed presentation, leading to delayed clinical attention. This report presents a case of extensive subcutaneous hematoma involving the lower abdomen and perineum following transperineal prostate biopsy in a patient diagnosed with PCa. Prompt management with prostatic artery angiography and superselective prostatic artery embolization, supplemented by endocrine therapy, resulted in rapid resolution of the hematoma. At three-month follow-up, tumor biomarkers remained stable, and key biochemical parameters had returned to pre-biopsy baseline levels, indicating favorable disease control and recovery.