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Prostate Biopsy

A prostate biopsy is a medical procedure in which small samples of tissue are taken from the prostate gland for examination under a microscope. Often, a prostate biopsy is used to find out whether or not a patient is suffering from prostate cancer or an inflamed prostate gland.

Also known as: prostate tissue sampling

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Everything you need to know

A biopsy is typically performed to investigate abnormalities detected during a prostate examination, such as an abnormal digital rectal exam (DRE), elevated prostate-specific antigen (PSA) levels and a prostate MRI.

There are different methods for performing a prostate biopsy, but the most common technique is an MRI/ Ultrasound fusion Transperineal Prostate (TP) Biopsy. An MRI of the prostate is initially performed to assess the size of the prostate and to see if there are any lesions (suspicious areas) in the prostate. After this, your doctor will collect small tissue samples for further investigation. To collect these, a small ultrasound probe is inserted into the back passage, which provides additional images of the prostate. By fusing the MRI and ultrasound images, your urologist can very precisely guide thin needles into the prostate and collect the necessary tissue samples.

Before

Before you come in for a prostate needle biopsy, you will already have done a series of tests. These will usually be a digital rectal exam, a blood test that detects elevated prostate-specific antigen (PSA) levels, and an MRI of your prostate.

If a prostate needle biopsy is recommended, you may also be asked to:

  • Provide a urine sample: this is to check for any urine infections.
  • Have urodynamic testing – to understand your voiding in more detail.
  • Stop taking certain medications: If you take any blood thinners—for example, warfarin or aspirin, you may need to stop taking these or modify your intake. Your doctor will give you specific instructions if this is the case.
  • Do a cleansing enema at home before your biopsy appointment.

MRI/Ultrasound fusion Transperineal Prostate biopsies can be performed under local anaesthetic or general anaesthetic. Your urologist will discuss the most appropriate option for you.

If you are having general anaesthetic, you should stop eating six hours before your procedure. Two hours before, you should stop drinking (including water), chewing gum and sucking boiled sweets.

It’s best to wear loose, comfortable clothes and bring a small bag with things you might need during your stay. Items to remember include your phone and a charger, and any prescription medications. Your doctor will let you know if you can take any medications with a sip of water before the procedure or if you should wait until after.

Once you have arrived and are settled in your room, a nurse will monitor your vital signs (such as body temperature and blood pressure) and run through your medical history, medications and emergency contacts.

Your doctor will then once again run you through the procedure and ask you to sign a consent form.

During

This involves inserting very thin needles into the prostate through the skin behind the testicles (perineum). A number of samples will be taken and these will be sent to a laboratory for testing.

In order to guide the needles to the correct place, an ultrasound probe will be inserted into your back passage. Your urologist will combine the images from your MRI and the ultrasound images to identify the precise areas from which to take the biopsies.

To collect these, your urologist will place a template or grid with many holes over your perineum and guide the needle through the template.

Samples from other areas of the prostate may also be required – these are called systematic biopsies. If your MRI did not show any specific areas of concern, you will only have systematic biopsies taken.

A transperineal biopsy usually takes about 45 minutes. Between 20 to 30 prostate samples will be taken.

After

After the procedure, we will take you to a private room and our nurses will monitor you to ensure there are no immediate complications.

If you had general anaesthetic, you will need someone to collect you and stay with you overnight as anaesthetic can make you feel very tired for around 24 hours. During this time you should not drink alcohol, cook or make important decisions.

You should aim to rest and only do light activities for 24 – 48 hours after the procedure. Your doctor may also prescribe an antibiotic to take in the following days.

It’s common to experience some discomfort after a prostate biopsy. After-effects include soreness, blood in the urine or stools, discomfort while urinating and a red tinge to the semen caused by a small amount of blood.

Your biopsy results will usually be ready one week after your procedure. Your urologist will discuss these with you at a follow-up appointment.

If you have concerns about the procedure or experience unusual symptoms afterwards, such as fever, heavy bleeding and pain, contact us for guidance straight away.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.