In 1930 Ferguson modified the technique and published his series of 280 patients who had prostate needle aspiration biopsy using an 18-gauge needle via the transperineal approach and was able to remove adequate tissue in 78 to 86% of his cases (Ferguson, 1930) (figure 6). The patient was placed in the lithotomy position and local anaesthetic was infiltrated just lateral to the median raphe 1cm anterior to the anus. The index finger of the left hand was introduced into the rectum guiding an 18 gauge needle introduced into the perineum taking care to avoid the rectum and urethra
