(TRUS guided prostate biopsy)
A prostate biopsy is a test to remove small samples of prostate tissue to be examined under a microscope. For a prostate biopsy, a thin needle is typically inserted through the rectum, under the guidance of an ultrasound (TRUS) probe. The tissue samples taken during the biopsy are examined for cancer cells by the pathologist.
A biopsy may be done when a blood test shows a high level of prostate specific antigen (PSA) or after a physical examination finds an lump in the prostate.
Why it is done
A prostate biopsy is done to determine:
- Whether a lump found in the prostate gland is cancer.
- The cause of a high level of prostate-specific antigen (PSA) in the blood.
How to prepare
Tell your doctor if you:
- Have had any bleeding problems.
- Are allergy to any medications, including anesthetics.
- Take any medications regularly. Be sure your doctor knows the names and doses of all your medications.
- Are taking any blood-thinning medications, such as warfarin, heparin, enoxaparin, aspirin, clopidogrel, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs).
A blood test (coagulation profile or PT/APTT/INR) is performed before the biopsy to ensure normal blood clotting ability of the body. An enema is usually given before the biopsy.
How it is done
Prostate biopsy is usually done as a daycare procedure with about half a day spent in the hospital. Before your prostate biopsy, you will be given antibiotics to prevent infection. You will be asked to change to hospital clothing. Transrectal ultrasound (TRUS) is used to guide the needle to the correct biopsy location. A prostate biopsy is usually done with a spring-loaded needle. The needle quickly enters the prostate gland and removes a tissue sample. Multiple tissue cores (12 – 14) are removed to represent all the areas of the prostate. Additional areas may be sampled if any suspicious area is has been detected on the prostate MRI performed earlier. A transrectal biopsy procedure usually takes about 5 minutes.
How it feels
For a transrectal biopsy, you may feel pressure in the rectum while the ultrasound probe or guiding finger is in place. You also may feel a brief, sharp pain as the biopsy needle is inserted into the prostate gland. Usually several biopsy samples are collected. With local anesthesia, most patients are able to tolerate this procedure well.
Following the biopsy, you will be asked to avoid strenuous activities for about 4 hours. You may experience some mild discomfort in the biopsy area for 1 to 2 days after the biopsy and may notice some blood in your urine. Also, you may have some discoloration of your semen for up to one month after the biopsy. If you had a transrectal biopsy, you may experience a small amount of bleeding from your rectum for 2 to 3 days after the biopsy.