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Prostate biopsy

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When one is advised to undergo a prostate biopsy, men often worry too much. The prostate gland is a vital organ of the male reproductive system. Complications like prostate gland enlargement and prostate cancer call for a biopsy wherein the tissues of the prostate gland are collected to analyze under the laboratory. The biopsy can lead to pain and bleeding in some cases, that causes general anxiety in men. We shall explain the details about prostate biopsy in the next segment. This will help you overcome any doubts you have regarding this simple biopsy procedure.

What is a prostate biopsy?

Just like any other biopsy, the basic technique remains the same, i.e. a sample of tissue from the prostate gland is removed with a special biopsyneedle which is then examined under a microscope to detect abnormalities. It could be performed as a diagnostic test separately or during a surgery.

Why is a prostate biopsy recommended?

Your doctor will not advise a biopsy on merely assuming something wrong in your prostate gland. Rather, if abnormalities are found in preliminary diagnostic tests like a digital rectal exam, transrectal ultrasound and blood tests, then a biopsy would be suggested as a confirmatory test.

A biopsy is done under the following medical conditions:

  • Blood tests that indicates prostate cancer due to high levels of prostate specific antigen (PSA)
  • Lumps, tumors, abnormal cell growth and other complications have been detected in ultrasound and DRE reports.  
  • To confirm prostate cancer and determine the stage of the cancer

How is a prostate biopsy performed?

There are 3 techniques for performing a prostate biopsy and they are:

  • The most common is the transrectal method, where the needle is reached to the prostate gland to collect the tissues via the rectal wall.
  • The transurethral method or cystoscopy entails passing a very fine tube (a tiny camera is attached at the tip) through the urethra to access the prostate gland.
  • Perineal biopsy involves making a tiny incisionin the perineum (the area between your anus and scrotum) to insert the biopsy needle and reach your prostate gland.

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How to prepare for prostate biopsy?

The preparations differ from one individual to another and also depend on the type of biopsy you are undergoing. The suggestions are:

  • In case of transrectal biopsy, you will have to take enema in the previous night or in the morning to empty your stomach
  • Your doctor might ask you to fast after midnight if you are undergoing transurethral method
  • You will be asked to stop taking medicines like anticoagulants and blood thinners or any other herbal supplements that may interfere with blood clotting

Apart from all these, you must notify your doctor if you are allergic to any substance like latex or anesthetic drugs, have pre-existing medical conditions or are taking any medicines (both OTC and prescription), supplements, etc.

What happens during the procedure?

Your doctor would give you a sedative to help you relax. You will be put under general anesthesia while undergoing a transurethral prostate biopsy, the rest two procedures will be performed under local anesthesia.

If it’s a transrectal method, then you have to lie down on your left side with your knees folded. The other two techniques entail lying down on your back with your knees bent and thighs apart.  A biopsy may be assisted by ultrasound for propervisualization of the prostate gland. You can sense prick and pressure when the needles are inserted into the skin to collect the tissues.

What happens after the procedure?

You will be discharged from the hospital only after your doctor is assured that you are stable. You may feel the urgency to pass bowel and urinate after it is over. Make sure someone accompanies you home. Streaks of blood may be observed with urine and stool for a few days and you might be prescribed painkillers to manage soreness at the biopsy site.

Risks associated with prostate biopsy

Some risks involved are infection and bleeding in the biopsy site, discharge of bloody semen and difficulty in urination. Call your doctor immediately if you experience such abnormalities.

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Written by: Saptakee sengupta
Date last updated: April 19, 2015