A prostate biopsy is a procedure used to remove samples of suspicious tissue from the prostate. The prostate is a small walnut-shaped gland in men that produces fluid that nourishes and transports sperm.
During a prostate biopsy, a needle is used to collect a number of tissue samples from your prostate gland. The procedure is performed by a doctor who specializes in the urinary system and male sex organ (urologist).
Your urologist may recommend a prostate biopsy if results from initial tests such as prostate-specific antigen PSA blood test or a digital rectal exam, suggest that you may have prostate cancer If cancer.
The tissue samples are then examined under a microscope for cell abnormalities that are the signs of prostate cancer.
If cancer is present, it is evaluated to determine how fast it is likely to spread nd determine your best treatment options.
To prepare for your prostate biopsy, your urologist may have you provide a urine sample to analyze for urinary tract infection.
In the case where you have the infection, your prostate biopsy will likely be postponed while you take antibiotics to clear the infection.
Stop taking medication that can increase the risk of bleeding such as warfarin, aspirin, ibuprofen and others.
Do a cleansing enema at home before your appointment. Take antibiotics 30 to 60 minutes before your prostate biopsy to help prevent infection from the procedure.
Read on to learn more about what to expect before, during, and after your prostate biopsy.
Types of prostate biopsy procedures Prostate biopsy samples can be collected in different ways.
Your prostate biopsy may involve:
Passing the needle through the wall of the rectum. This is called a transrectal biopsy, and it is the most common way of performing a prostate biopsy.
Collecting a tissue sample through the tip of the penis. This way of performing a prostate biopsy is called a transurethral biopsy. A long, thin tube equipped with a camera is passed through the opening (urethra) at the tip of the penis in order to access the prostate.
Inserting the needle through the area of skin between the anus and scrotum. This type of prostate biopsy involves making a small cut in the area of skin (perineum) between the anus and the scrotum.
The doctor inserts the biopsy needle through the cut and into the prostate to draw out a sample of tissue. What to expect during transrectal prostate biopsy. In most cases, the urologist performs a transrectal prostate biopsy.
For this procedure, your doctor will start by having you lie on your side, with your knees pulled up to your chest. In some cases, you may be asked to lie on your stomach. After cleaning the area and applying gel, your doctor will gently insert a thin ultrasound probe into your rectum.
Transrectal ultrasonography is used to create images of your prostate using sound waves. Your doctor will use the images to identify the area that needs to be numbed with an anesthetic injection if one is used.
The ultrasound images are also used to guide the prostate biopsy needle into place. In most cases, an injection of a numbing medication is used to reduce the discomfort associated with the prostate biopsy.
A needle is used to inject the anesthetic at various points near the base of the prostate. Once the biopsy device is situated, your doctor will retrieve thin, cylindrical sections of tissue with a hollow, spring-propelled needle.
The procedure typically causes a very brief, uncomfortable sensation each time the spring-loaded needle takes a sample. Your doctor may target a suspicious area to biopsy or may take samples from several places in your prostate.
In most cases, doctors will take 10 to 12 tissue samples. The entire procedure usually takes about five to 10 minutes. After the procedure After a prostate biopsy, you'll probably need to take an antibiotic for a few days.
You may feel slight soreness and have some light bleeding from your rectum. You may have blood in your urine or stools for a few days.
You may also notice that your semen has a red or rust-colored tint caused by a small amount of blood in your semen. This can last for several weeks.
Call your doctor if you have:
- Prolonged or heavy bleeding
- Pain that gets worse
- Swelling near the biopsy area
- Difficulty urinating
In rare cases, a prostate biopsy can lead to infection. If you have any signs of infection, call your doctor.
Signs and symptoms of infection include:
- Pain when urinating.
- Discharge from your penis
Understanding the results of your prostate biopsy will be made possible by your doctor.
A doctor who specializes in diagnosing cancer and other tissue abnormalities (pathologist) will evaluate the prostate biopsy samples.
The pathologist can be able to determine if the tissue removed is cancerous and, if cancer is present, estimate how aggressive it is. You doctor will explain the results of the analysis to you.
Your pathology may include:
A description of the biopsy sample. This is sometimes called the gross description, this section of the report may evaluate the colour and consistency of the prostate tissue.
A description of the cells. You pathology report will also describe the wy the cells appear under a microscope. The prostate cancer cell may be referred to as adenocarcinoma.
In some cases, the pathologist finds cells that appear abnormal but are not cancerous. Terms used to describe these noncancerous conditions include "prostatic intraepithelial neoplasia" and atypical small acinar proliferation."
Cancer grading. If the pathologist finds cancer, it is graded on a scale of 2 to 10. This is known as a GLEASON score. Cancers with a high Gleason score are the most abnormal and are more likely to grow and spread quickly.
The pathologist's diagnosis. This section of the pathology reports ha a list of the pathologist's diagnosis. It can also include comments such as weather other tests are recommended.