What is a prostate biopsy?
A prostate biopsy is a procedure in which samples of tissue are removed from your prostate gland and then examined under a microscope to help diagnose cancer and other conditions. The prostate gland produces part of the semen and is found underneath the bladder. It surrounds the urethra (the tube that carries urine from the bladder out of the body).
Your surgeon will usually recommend a prostate biopsy if earlier tests have shown a high level of prostate-specific antigen (PSA) or if a lump or enlarged prostate has been found during a rectal examination. A prostate biopsy is routinely done as an out-patient or day-case, with no overnight stay in hospital.
The biopsy is usually taken using fine needles passed through the wall of your rectum under ultrasound guidance. This is called a transrectal ultrasound-guided biopsy. Most transrectal biopsies do not need anaesthesia or sedation. However, sometimes a local anaesthetic may be used to numb the area beforehand.
A prostate biopsy can also be taken via the urethra, or via the area between the anus and scrotum (the perineum). These methods are less common and do require anaesthesia. Your surgeon will advise which method is most suitable for you.
Your surgeon will explain the benefits and risks of having a prostate biopsy, and will also discuss any alternatives to the procedure.
About the procedure
The test takes about 15 to 30 minutes to complete and is usually done in the X-ray or out-patient department.
An ultrasound machine is used to view the prostate and guide the biopsy needles. Your surgeon will carefully pass a lubricated ultrasound probe into your rectum via your anus. The probe will feel uncomfortable, but should not be painful. An image of your prostate will be displayed on a video screen.
Your surgeon will then use a special biopsy instrument to insert and remove the needles. This is a quick procedure that takes seconds to complete. However, you may feel a sharp stinging sensation as the needles are inserted. Some men find the procedure quite painful so you may be given a local anaesthetic beforehand.
The needles are passed down the shaft of the ultrasound probe and through the wall of the rectum into the prostate gland. The needles collect the tissue samples and are then pulled out. At least six samples are collected to ensure that different areas of the prostate are checked.
The tissue samples are sent to a laboratory for examination. The laboratory results are usually sent in a report to your surgeon. Your surgeon will review the results and discuss them with you at your follow-up appointment. The results will hopefully give a better understanding of your medical condition and your surgeon will offer suitable advice and treatment.
After the biopsy, your rectal area may feel tender but this should ease quickly. You may notice some blood in your urine or stools for a few days. In some cases, slight bleeding can last for several weeks.
It is possible that your semen may have some blood in it or appear discoloured for a month or two. It is also possible, but uncommon, to have some difficulty in passing urine after the procedure.
A prostate biopsy is a commonly performed and generally safe procedure. For most men, the benefits of having a clear diagnosis are greater than any disadvantages. However, all surgery carries an element of risk.
There is a chance you may develop an infection. This is because there are many bacteria in the rectum, and the biopsy needles pierce the wall of the rectum. It is important you complete your course of antibiotics to reduce the risk of infection.
It is reassuring if no cancer is found, but a normal test result cannot completely rule out cancer. This is because the biopsy samples are very small, and there may be cancer elsewhere in your prostate that the needles didn’t pick up. If your surgeon suspects this, you will be advised to have a repeat biopsy after several months. At least six samples are taken at each biopsy to try and avoid a false result.
The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. Ask your surgeon to explain how any risks apply to you.
To find out more about having a prostate biopsy in a Spire Healthcare hospital, please call our treatment enquiry team on 0800 434 6600.
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