Prostate Biopsy

A prostate biopsy is a procedure which is utilized to remove samples from the tissue in the prostate gland for the purpose examination in order to make a determination regarding a number of prostate problems. In a transrectal prostate biopsy a needle is inserted through the rectum, through the urethra. A prostate biopsy may also be performed by inserting the needle through the area located between the anus and the scrotum, known as the perineum. The transrectal prostate biopsy is the most commonly used technique. Once the tissue samples have been obtained, they are examined through a microscope to observe the presence of cancer cells.

Many times a prostate biopsy may be needed if a blood test known as a PSA has indicated that there is a high level of a particular protein present. The high level of this protein may indicate the presence of cancer. A prostate biopsy may also be performed when a digital rectal exam indicates that there is a lump or an enlarged prostate present.

If there is a lump or a high level of PSA, the doctor will want to determine whether there may be cancer present as a result. The most important things to keep in mind before a prostate biopsy is to inform your doctor if you have any allergies, including allergic reactions to latex, anesthetics or any other type of medication. You should also let your doctor know if you are taking any other types of medications or antibiotics as this can interfere with anesthesia. Due to the fact that there may be some bleeding present during the prostate biopsy, patients should especially inform their doctor if they are taking any anticoagulants. As aspirin is considered to be a blood thinner, patients should also inform their doctor if they take aspirin on a regular basis. Finally, the doctor will need to be aware if patients have a tendency to bleed easily.

If the doctor plans to do a transrectal prostate biopsy, they will usually order an enema the night before the test. Patients may also be required not to drink any fluids at least 12 hours before the prostate biopsy.

It is quite common for patients to receive a sedative that will help them relax during the prostate biopsy procedure. Antibiotics are also commonly used to reduce the risk of infection. Depending on how the doctor intends to perform the prostate biopsy, the patient may be asked to lie on their side, stomach or on their back with their feet in stirrups. A kneeling position may also be requested. A prostate biopsy usually does not take very long and patients are surprised that it can be accomplished so quickly.

A transurethral prostate biopsy is performed a little differently and most patients are requested to lie on their back with their feet in stirrups for this procedure. A general anesthetic is usually used to numb the area where the needle will be inserted. In this type of prostate biopsy a lighted scope is frequently used and will be inserted in the urethra. This lighted scope allows the doctor to see the prostate gland. A special instrument is then inserted into the scope and allows the doctor to cut small pieces of tissue from the prostate gland. This procedure is also fairly quick and rarely lasts longer than 45 minutes.

The least commonly performed prostate biopsy is the transperineal biopsy. In this type of procedure the surrounding area will be cleaned and a local anesthetic is used. If the patient requests it, general anesthetic may also be used. The doctor will make an incision in the perineum, insert a finger into the rectum and then insert the needle into the prostate gland. Bandages may be used to quell the bleeding from the incision. This type of prostate biopsy normally lasts anywhere from between 15 to 30 minutes.

With all three types of prostate biopsy, the patient will usually be asked to refrain from vigorous activity for at least several hours. For a few days following the procedure, the patient may have some mild discomfort and may need to take a mild pain pill. The patient may also notice a slight amount of blood in their urine or semen, even up to one month following the prostate biopsy. Although this is quite normal, the patient should report immediately to their doctor if they experience any persistent bleeding, increase in pain, a fever higher than 100 degrees or if they are unable to urinate within 8 hours following the prostate biopsy.

As with any medical procedure there are risks related to a prostate biopsy. Although they are slight risks, the patient should still understand that there is a risk for an infection. An infection risk is much more common if the patient has undiagnosed prostatitis. In most cases antibiotic medication used during the prostate biopsy procedure will keep an infection at bay. There is also the chance of bleeding into either the urethra or bladder. A hemotoma, also known as a blood blister, may occur which will cause the patient to be unable to urinate. Although most patients who undergo a transrectal prostate biopsy experience some bleeding for a day or two following the procedure, there is a risk for persistent bleeding.

One of the most difficult parts following a prostate biopsy is waiting for the test results, which may take up to 10 days. The results of the prostate biopsy will be presented as either normal or abnormal. If the results are abnormal, they may indicate there was either cancer cells present or that it appeared there was an enlargement of the prostate gland present. While most prostate biopsy tests are accurate, if there was not enough tissue collected, it may be possible that the test results are inconclusive. If this is the case, the doctor may need to order additional tests such as a bone scan, blood test or CT scan. Many men are reluctant to undergo a prostate biopsy because of rumors that it interferes with a man's ability to achieve an erection or will cause a man to become infertile. Neither of these are true and it is imperative that man who experiences any symptoms related to prostate disorders have a prostate check and biopsy, if needed, immediately.