A prostate biopsy is a medical procedure that involves collecting small tissue samples from the prostate gland. These samples are examined under a microscope to determine the presence of prostate cancer or other prostate conditions.
Reasons for a Prostate Biopsy
A doctor may recommend a prostate biopsy when initial screening tests indicate potential issues. Primary indicators include an elevated Prostate-Specific Antigen (PSA) level in a blood test or an abnormal finding during a digital rectal exam (DRE). These tools suggest the need for further investigation, with the biopsy serving to confirm or rule out prostate cancer.
Pre-Procedure Preparations
Before a prostate biopsy, patients typically receive specific instructions for a safe and effective procedure. Patients must discuss all current medications with their doctor, especially blood thinners, as these may need to be stopped several days before the biopsy to reduce bleeding risk. Patients are often advised to take antibiotics prior to the procedure to minimize infection risk. Depending on the type of anesthesia and specific clinic, dietary restrictions, such as fasting for a few hours, may apply. A cleansing enema may be required at home to prepare the rectum. If sedation is used, arrange for transportation home after the procedure.
The Biopsy Process
The prostate biopsy procedure involves several steps designed to collect tissue samples for examination. The patient typically lies on their side with knees drawn towards the chest. To ensure comfort, local anesthesia is injected around the prostate to numb the area, though light sedation might also be offered.
Imaging guidance, most commonly transrectal ultrasound (TRUS), is used to visualize the prostate and direct the biopsy needle. An ultrasound probe, coated with gel, is gently inserted into the rectum, providing real-time images of the prostate on a screen. In some instances, magnetic resonance imaging (MRI) scans taken prior to the biopsy may be used to guide the targeting of suspicious areas.
A thin, hollow needle is then quickly inserted to collect small tissue samples, often referred to as cores. Typically, 10 to 12 tissue samples are collected from different areas of the prostate. There are two main approaches for the biopsy: transrectal and transperineal. The transrectal approach passes the needle through the rectal wall into the prostate and is the most common method. The transperineal approach inserts the needle through the skin between the scrotum and anus (the perineum). This method may reduce infection risk as it avoids the rectum. The entire biopsy procedure usually takes 10 to 30 minutes.
Post-Biopsy Care and Expectations
Following a prostate biopsy, patients can expect a brief recovery period. Many individuals are able to go home the same day, though a short rest period might be recommended. Patients are advised to engage only in light activities for 24 to 48 hours and avoid strenuous physical activity, such as heavy lifting or intense exercise, for several days to a week. Sexual activity should also be avoided for a few days to a week.
Common side effects include seeing blood in the urine, stool, or semen. Blood in the urine or stool typically resolves within a few days to a week, while blood in semen can persist for several weeks or even up to two months, appearing red or dark brown. Mild discomfort or soreness in the rectal or perineal area is also common and can usually be managed with over-the-counter pain relievers. Drinking plenty of fluids is encouraged to help flush the urinary tract and minimize infection risk.
Patients should contact their doctor if they experience signs of infection, such as a fever above 101°F (38°C), severe pain, heavy or persistent bleeding, or difficulty urinating. After the procedure, the collected tissue samples are sent to a laboratory for pathological examination. Results are typically available within a few days to a couple of weeks, and a follow-up appointment is usually scheduled to discuss the findings and next steps.