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. 2025 Jul 30;6(8):e70063.
doi: 10.1002/bco2.70063. eCollection 2025 Aug.

The carbon footprint of transperineal prostate biopsy

Daniel A Carson  1   2 , Ali Hooshyari  1 , Jesse Gale  3 , Greg Evans  4 , Flavio V Ordones  1   2 , Lodewikus P Vermeulen  1   2
Affiliations

The carbon footprint of transperineal prostate biopsy

Daniel A Carson et al. BJUI Compass. .

Abstract

Objective: To evaluate the carbon footprint of transperineal prostate biopsy (TPPB). Climate change is the biggest global public health threat of the 21st century. Healthcare contributes 5% to global greenhouse gas emissions. Despite growing enthusiasm for sustainable urology, there is little data on the environmental impact of urological practice.

Patients and methods: Emissions associated with TPPB (under local anaesthesia) at a hospital in Aotearoa New Zealand were estimated from electricity consumption, procurement of equipment/supplies, travel of staff and patients, waste disposal and sterilisation of linen. Emissions coefficients were used to determine CO2 equivalents (kgCO2e) emitted.

Results: TPPB was associated with 70 kgCO2e of emissions per case. This equates to 280 km of travel by car, or an economy seat on a 70-minute flight. The largest contributors were procurement (76%) and travel (23%). Electricity, waste disposal and sterilisation of linen did not contribute significantly to emissions (cumulatively <1.5%).

Conclusions: This is the first study to evaluate the carbon footprint of a TPPB. Emissions were derived mostly from procurement and travel. These may be mitigated by review of standardised equipment packs, transitioning to reusables and introducing outreach biopsy clinics. Adherence to pragmatic evidence-based guidelines for prostate cancer may reduce emissions associated with overdiagnosis and unnecessary biopsies. Further research is required to characterise the broader environmental impact of urology services.

Keywords: carbon footprint; prostate biopsy; prostate cancer; sustainability.

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Conflict of interest statement

DAC, AH, JG, GE, FVO and LPV have no relevant conflicts to declare.

Figures

FIGURE 1
FIGURE 1
Contributions by emissions source to the carbon footprint (kgCO2e) of a transperineal prostate biopsy.
See this image and copyright information in PMC

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