TransPERineal Fusion Biopsy Versus transrECTal

Inclusion Criteria:

* Patient having had a multiparametric prostatic MRI with the realization of 3 sequences (T2, diffusion, perfusion) interpreted by a local referent radiologist in prostate MRI or whose PI-RADS score is confirmed by rereading by a local referent radiologist in prostate MRI in case prostate MRI performed outside the center;
* Patient with at least one PI-RADS 4-5 lesion on MRI;
* Patient eligible for prostate, transperineal and transrectal biopsies, targeted and systematized;
* Patient with negative pre-biopsy antibacteriological urine examination ;
* Patient with prostate specific antigen (PSA) level ≤ 20 ng / mL;
* Patient capable of understanding the information related to the study, answering questionnaires in French, reading the instructions and having expressed their consent to participate in the study.

Exclusion Criteria:

* Patient who has already had a prostate biopsy;
* Patient with stage ≥ cT3a prostate cancer according to TNM classification version 8
* Patient with negative MRI or whose lesions have a PI-RADS score \<4;
* Patient with impassable rectal stenosis;
* Patient with a dermatological disease preventing perineal access;
* Patient with rectal amputation;
* Patient presenting with a urinary tract infection;
* Patient on anticoagulant treatment at an effective oral dose, not relayed;
* Patient participating in another clinical trial, or in a period of exclusion from another clinical trial