Prostate Biopsy


1. What is a prostate biopsy?

2. What does it consist of?

3. Why is it performed?

4. Preparation for the prostate biopsy

5. What does the test feel like?

6. Meanings of abnormal results

7. Advances

What is a prostate biopsy?

A prostate biopsy is a test performed to take small samples of prostate tissue, which are then examined in more detail and analyzed.

The test is performed on an outpatient basis and under local anesthesia or sedation.

What does it consist of?

There are generally three types of prostate biopsy. The first is called a transrectal ultrasound (TRUS) guided biopsy. First, an ultrasound probe is inserted into the rectum to allow imaging of the prostate. After this, a biopsy needle is inserted and samples are taken. On average, about ten samples are taken using this method.

The second type of prostate biopsy is called a transperineal (template) biopsy. In this method, more samples are taken from different areas of the prostate. About thirty to fifty samples can be taken using a template biopsy by inserting an ultrasound probe into the rectum. In the template biopsy, the needle is inserted into the prostate through the skin between the testicles and the perineum.

The third type is the transurethral biopsy. In which a light endoscope, cystoscope, is inserted into the urethra to extract samples of the prostate tissue. The test takes about 30-45 minutes.

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Prostate biopsy checks for the presence of cancer.

Why is it done?

Prostate biopsies are performed to check for the presence of prostate cancer. Template biopsy is typically performed in those who have health problems that do not allow for a guided biopsy (ETR), or if a transrectal ultrasound-guided biopsy has been taken, but the physician suspects that prostate cancer is still present.

Preparation for a prostate biopsy

No specific preparation is needed, but since a template biopsy is performed under general anesthesia, it is helpful to have someone come for you after the procedure.

However, to prevent complications such as bleeding or infection, it is advisable to stop taking antiplatelet and blood thinners, have a rectal enema and take an antibiotic to prevent infection.

How do you feel during the test?

If you are having an ETR biopsy, local anesthesia is used, which means the area is numbed. The procedure can be a bit uncomfortable despite this, as you have to lie on your side with your knees drawn up towards your chest. A gel is used when inserting the probe to facilitate the process. The procedure only takes 10-15 minutes. You may feel some discomfort in the rectum after the procedure and in the days immediately following.

In a template biopsy, general anesthesia is used, which means you will not be conscious for the actual test. The test takes about 20-40 minutes, and you will need to stay in the clinic for a few hours afterwards to recover from the anesthesia.

What do the results mean?

After the biopsy, the samples are sent for study. Each sample will be analyzed to see if it contains cancer, and how present it is in each sample. If cancer is found, the doctor will be able to tell how aggressive the cancer is and whether it is likely to spread. They will also be able to tell you the type of cancer, if present.

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If cancer is found, the doctor will explain what the results mean and what the next steps are for treatment.

If cancer is not found, but the doctor suspects prostate cancer is present, he or she may order additional tests or another biopsy.

Advances in prostate biopsies

Advances in medicine mean that biopsies are becoming more specific, and the need for frequent biopsies is greatly reduced. High-quality MRI machines can be used to detect prostate cancer, and if a biopsy is necessary. A more precise type of biopsy, called transperineal MRI-ultrasound fusion biopsy, can be offered. In this test, the needle is inserted through the perineum instead of the rectum.