Prostate Biopsy Procedure

A biopsy is a procedure performed to remove cells or tissues of the body for examination under a microscope. A prostate biopsy is a procedure in which tissue samples are removed from the prostate with a special biopsy needle or during surgery to determine the presence of cancer or other abnormal cells. A cancer diagnosis is confirmed only by biopsy.

You can perform a biopsy of the prostate in several ways:

• transrectal method: through the rectum (this is the most common)
• perineal approach: through the skin between the scrotum and rectum
• transurethral method: through the urethra using a cystoscope (a flexible tube and viewing device)

Another procedure that can be used to evaluate the prostate is a sonogram of the prostate or rectum. See this procedure for additional information.

Reasons for the Procedure

A prostate biopsy is done after other tests indicate a prostate problem. The most common tests are:

• digital rectal examination (DRE): The doctor inserts a lubricated, gloved finger into the rectum to feel the prostate and detect anomalies
• prostate specific antigen (PSA) blood tests that may suggest the presence of prostate cancer
• transrectal ultrasound (TRUS): a test using sound wave echoes to create images of the prostate in order to visually inspect for abnormal conditions such as enlargement of the gland, nodules or tumors

You can perform a prostate biopsy to diagnose prostate cancer and determine the cause of enlarged prostate.
Your doctor may recommend a prostate biopsy for other reasons.

Risks of the Procedure

As in any surgical procedure, complications can occur. Some possible complications may include, inter alia:

• bruising and discomfort in the area of the biopsy
• prolonged bleeding from the biopsy area
• infection near the biopsy area
• difficulty urinating

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

Before the procedure

• The doctor will explain the procedure and give him the opportunity to ask any questions you may have about the procedure.
• You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• Tell your doctor if you are sensitive or allergic to any medications, latex, tape, or anesthetic agents (local and general).
• Tell your doctor about all medications (prescription and OTC) and herbal supplements you take.
• Tell your doctor if you have a history of bleeding disorders or are taking anticoagulant drugs (blood thinners), aspirin or other medications that affect blood clotting. You might need to stop taking these medications before the procedure.
• In general, no prior preparation, such as fasting or sedation for transrectal or perineal approach. If you are using the transurethral method, you can use general anesthesia. If you have general anesthesia, it may be asked to fast before the procedure, generally after midnight. The doctor will give specific instructions.
• If the physician uses the transrectal method, you may need to take an enema the night before or morning of the biopsy.
• You may receive a sedative before the procedure to help you relax. Because the sedative may numb, need someone to drive you home. This is most likely if your doctor uses the transurethral approach.
• Depending on your medical condition, your physician may request other specific preparation.

During the procedure

A prostate biopsy is usually performed on an outpatient basis. Procedures may vary depending on your condition and your physician's practices.
Generally, a prostate biopsy is one of these processes:

transrectal method:

• You will be asked to remove clothing and will be given a gown to wear.
• You will be positioned on the left side, knees bent. You must remain still during the procedure.
• This method can be performed under local anesthesia.
• In general, be used transrectal ultrasound (TRUS) to guide placement of biopsy needle.
• Your doctor will insert a needle into the prostate through the rectal wall. You may feel discomfort or pressure when the needle enters the prostate. Sometimes they use a small spring-loaded biopsy, which is said to be virtually painless.
• The physician will obtain several tissue samples from different parts of the gland.
• The sample of prostate tissue sent to the laboratory for analysis.

perineal method:

• You will be asked to remove clothing and will be given a gown to wear.
• You will be positioned on the left side with your knees bent and your back with knees bent and legs apart. You must remain still during the procedure.
• It will clean the skin between the scrotum and rectum with an antiseptic solution.
• You will feel a sting when you inject the local anesthetic. This could cause a brief stinging sensation.
• When the area is numb, the doctor makes a small incision in the skin.
• The doctor will introduce a lubricated, gloved finger into the rectum to locate and stabilize the prostate.
• The biopsy needle is inserted several times into the prostate to obtain samples from different parts of the gland.
• Will withdraw the biopsy needle and apply firm pressure in place to stop the bleeding.
• The sample of prostate tissue sent to the laboratory for analysis.

transurethral method:

• You will be asked to remove clothing and will be given a gown to wear.
• He is lying on your back with knees bent and legs apart.
• The procedure can be performed under local or general anesthesia.
• Your doctor will insert a cystoscope (a flexible tube and viewing device) into the urethra through the hole at the tip of the penis.
• The physician will insert instruments through the cystoscope to obtain samples of the prostate.
• The sample of prostate tissue sent to the laboratory for analysis.

After the procedure

The recovery process will vary depending on the type of anesthesia used. If you received general anesthesia, you'll be taken to the recovery room for observation. Once blood pressure, pulse and breathing are stable and you are alert, you take the room or give the discharged to go home.
If local anesthesia is used, you can resume your normal diet and activities unless your physician advises otherwise. After the biopsy may feel the need to urinate or defecate. This feeling should disappear after a few hours.
You may have blood in urine or feces for several days after the biopsy. It is common for this to happen. In addition, ejaculation may be red or brown for several weeks after the biopsy.
The area of the biopsy may be tender or sore for several days after the biopsy. Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Tell your doctor if any of the following symptoms:

• increased amount of blood in the urine or stool
• difficulty urinating
• fever and / or chills

It is possible that your doctor gives you additional or alternate instructions after the procedure, depending on your specific situation.