Prostate Problem Guide
What Is The Procedure For Prostate Biopsy?
Although you doctor may suspect that you have prostate cancer the only was to be certain is to carry out a prostate gland biopsy in which one or more small samples of tissue are taken from the prostate gland for microscopic examination. But just what is the procedure for prostate biopsy?
A prostate biopsy will be carried out by a urologist (a doctor specializing in men's urinary problems) either in the doctor's office, a day surgery clinic or hospital and can take one of three forms.
In the first form of biopsy, which is known as a transrectal biopsy, you will normally be asked to kneel, lie on your side or lie on your back with your feet elevated in a pair of stirrups. The doctor will then inject a local anesthetic around the prostate gland before starting the procedure.
The transrectal biopsy is normally done using a spring loaded needle which is guided to the site from which tissue is to be taken by an ultrasound probe. In cases where the cancer can be felt during a digital rectal examination the doctor may use a gloved finger to guide the needle rather than an ultrasound probe. In either case, once in position, the needle is used to collect a small tissue sample which is removed and sent for microscopic laboratory examination. A transrectal biopsy usually takes about 30 minutes.
The second form of biopsy is referred to as transurethral biopsy and, as it's name suggests, the sample tissue is collected through the urethra. A lighted scope known as a cystoscope is inserted into the urethra, which passes through the prostate gland, and a cutting loop is then inserted into the cystoscope and used to collect a sample of tissue from the prostate. This procedure can be carried out either using a local anesthetic or general anesthesia and normally takes about 30 to 45 minutes.
The third form of biopsy is known as a transperineal biopsy. A small incision is made in the perineum (the area between the anus and scrotum) and the doctor then inserts a finger into the rectum to hold the prostate in position while at the same time inserting a biopsy needle through the incision in the perineum and into the prostate gland to remove a sample of tissue. This form of biopsy is less common than the other two forms these days and is usually carried out under either local or general anesthetic and takes about 15 to 30 minutes.
In cases where a biopsy is carried out under local anesthetic patients are likely to feel a slight stinging sensation when the local anesthetic is administered and, in the case of a transrectal biopsy, a very brief but sharp pain as the biopsy needle enters the prostate gland.
Following the biopsy patients will normally experience some mild discomfort for a couple of days and may also notice some blood in the urine. There may also be some slight bleeding from the rectum in the case of a transrectal biopsy. In all cases there may be some discoloration of the semen for a period of three to four weeks.
There is also a small risk that the biopsy itself can give rise to an infection or cause bleeding into the urethra or bladder. In rare cases the patient may also have an allergic reaction to the anesthetic used during the procedure. Patients who experience increased pain or a fever, heavy bleeding (or bleeding which continues for more than two or three days after a biopsy) or difficulty in urinating should consult their doctor without delay.