What is a Prostate Biopsy?

A prostate biopsy is a surgical procedure that is used to remove a sample of a suspicious tissue from your prostate for further examination analysis. The prostate is a tiny, walnut-shaped gland found in men's reproductive system. This gland's major function is to produce a fluid that nourishes the sperms and aid their transportation. During a prostate biopsy, your surgeon may use a needle to remove a certain number of tissues from the prostate gland. This procedure is performed by a urologist, a specialist whose expertise is on men’s sex organs and the urinary tract.

A urologist may opt for a prostate biopsy in case all other initial tests such as prostate specific antigen blood test (PSA) or digital rectal exam fail to provide concrete results about your prostate. Tissue samples taken during prostate biopsy are examined under a powerful microscope to check for any abnormalities or prostate cancer. If you have prostate cancer, it is closely evaluated to see how quickly it spreads and the possible treatments to offer.

Why is it done?

A prostate biopsy is mainly used to detect prostate cancer. Your doctor will recommend a biopsy of the prostate if:

• A PSA test antigen levels are higher than normal depending on your age.
• You have a previous biopsy that showed that your prostate cells were abnormal but not cancerous.
• You have a previous normal biopsy but with high PSA levels than your age.
• Your doctor gets a lump or any other type of abnormality when performing a digital rectal examination.

How to prepare for prostate biopsy

Below are some things you should do or expect in preparation for a prostate biopsy:

• An explanation about the entire procedure will be explained to you by your doctor and you will be required to ask questions.
• You will be required to sign a consent form to show that you understand how the procedure is performed and its possible risks and future complications.
• You need to discuss with your doctor in case you are allergic to anesthetic medications.
• You should provide a list of all the drugs you take regularly either prescribed or over-the-counter drugs and all herbs, supplements, and vitamins that you are using.
• You should also inform your doctor if you have bleeding disorders or you are taking any blood thinning medications such as ibuprofen and aspirin. You will be needed to stop such medications one week before prostate biopsy
• No special preparation will be required, such as fasting and sedation, if you will undergo perineal or transrectal biopsy procedures.
• You may be required to use an enema 8-12 hours before having a transrectal biopsy.
• You will be given a sedative to help you relax during the procedure. You should therefore make arrangements for someone to take you home after the procedure.
• To prevent infections, you will be required to start taking antibiotics a day before the procedure and then continue them after the procedure.
• You should follow every instruction given by your doctor to get perfect results for prostate biopsy.

How it is done

Biopsy of the prostate is mainly done as an outpatient procedure. These procedures may therefore vary depending on the prostate condition and the practices being provided by your health care provider.

The following are types of prostate biopsies:

1. Transrectal method

• The first step in this procedure is removing your clothes and putting on a hospital gown
• You will lie on your left side while bending your knees
• Local anesthesia is then injected to numb the cells where the needle will pass through
• Ultrasound is then used to guide the needle to the prostate gland
• A spring loaded tool is then used to insert the biopsy needle through the rectum wall to the prostate gland
• The needle is put on the gland several times to collect enough and variable samples of your prostate gland
• The tissue samples are then sent to the lab for analysis

2. Transurethral method

• You will first remove your clothes and wear a hospital gown
• You will then be positioned on your back with thighs apart and knees bent
• An injection of general anesthesia is then given to put you into a deep sleep during the procedure
• A cystoscope is then inserted through the opening of your penis, through the urethra and finally to the prostate gland
• A tiny needle is then inserted through the cystoscope to collect samples of your prostate gland
• The cystoscope is removed and then the samples are sent to the lab for examination

3. Perineal method

• As any other type of prostate biopsy procedure, you will be required to remove your clothes and wear a hospital gown
• You will then lie on your left hand side while bending your knees. You can also lie on your back with your thighs apart and knees bent
• The skin between the rectum and scrotum is cleaned with an antiseptic solution
• The area is then numbed with a local anesthesia then a tiny incision is made on the area
• A gloved and lubricated finger is placed on the rectum to help stabilize and locate the prostate gland
• A biopsy needle is then inserted through the incision to the prostate gland several times to collect enough samples from different parts of your prostate gland
• The biopsy needle is removed and then pressure is applied on the site of biopsy to stop excessive bleeding. There is no need for stitches
• The prostate tissue samples are finally sent to the lab for examination

Risks

Some of the complications associated with prostate biopsy include:

• Bacterial or fungal infection that is common to men with prostatitis. Antibiotics are used to prevent infections
• Excessive bleeding in the bladder or the urethra. This may cause a blood blister and problems with urination
• Bleeding from the rectum. This mostly happens when you have a transrectal biopsy.
• Allergic reactions as a result of anesthetics used during the procedure

You should call your doctor in case you have:

• A fever or chills
• Have intensifying pain
• You are unable to urinate after 8 hours
• You have blood in the urine for more than 2 days
• Have excessive bleeding lasting for more than 2 days

Bottom Line

A prostate gland biopsy is a medical test that is used to collect small samples of your prostate gland and then have them examined under a microscope. The procedure is very simple and the results are available within 10 days. The results are said to be normal if there are no infections founds in the prostate gland samples. The results are said to be abnormal if cancerous or infected cells are found in the samples.