use strict;
my $str = 'Lorem ipsum [TITLE|prefix=a] dolor [sit] amet [consectetur] [TITLE]';
my $regex = qr/(\[TITLE(?:\|[^\][]*)?)]/mip;
my $subst = '$1|suffix=z]';
my $result = $str =~ s/$regex/$subst/rg;
print "The result of the substitution is' $result\n";
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for Perl, please visit: http://perldoc.perl.org/perlre.html