What is a Prostate Biopsy?
A prostate biopsy is an outpatient procedure used to get samples of prostate tissue. Prostate biopsies are ordered when a blood test shows elevated prostate-specific antigen levels, if a doctor determined that the prostate felt abnormal during a manual examination or if the prostate appears abnormal in a transrectal ultrasound.
Preparation for a Prostate Biopsy
One week before the scheduled prostate biopsy, the patient is instructed to discontinue taking medications that can affect blood clotting. A patient should inform the doctor of any prescription medications currently being taken. The doctor will instruct the patient of which medications to avoid. Over-the-counter medications, new prescription medications and herbal supplements should never be taken without prior doctor approval. Common medications to avoid are aspirin, ibuprofen, acetaminophen, warfarin, clopidogrel and coumadin.
A patient should perform an enema at home the night before or the day of the surgery to clear the bowels of feces and lower the risk of infection from the prostate biopsy procedure.
Patients are given oral antibiotics 1 hour before the procedure to minimize the risk of infection.
How a Prostate Biopsy is Performed
The most common type of prostate biopsy is the transrectal method. In a transrectal biopsy, the doctor gains access to the prostate through the rectum.
Prior to a transrectal biopsy, the doctor instructs the patient to lie on his side in a fetal position (knees bent and pulled closed to the chest).
The doctor cleans and applies a topical numbing agent to the biopsy site before beginning the procedure. Once the numbing agent takes affect, the doctor inserts an ultrasound probe into the rectum. The ultrasound probe allows the doctor to view images of the biopsy site on a screen. Once the biopsy site is identified, an anesthetic is injected into the site and a prostate biopsy tool is inserted into the rectum. The prostate biopsy tool is fitted with spring-loaded needles that retrieve small samples of the prostate tissue. Typically, 10 to 12 prostate tissue samples are taken during the biopsy. Because anesthetic is used, any discomfort experienced during the procedure is minor.
Post-Biopsy
After a prostate biopsy, the patient is prescribed oral antibiotics to minimize infection risk. Common symptoms that are experienced for 2 to 3 days after a prostate biopsy are soreness, minor rectal bleeding and small amounts of blood in the urine and stool. Small amounts of blood may be seen in the semen, making the semen appear a light pink or rusty color, for 1 month. The doctor should be informed if a fever, heavy bleeding, swelling, severe pain, problems urinating, painful urination or penis discharge develops.
The test results from the prostate biopsy take up to 10 days to be available.
