Prostate biopsy – why and when?

Prostate biopsy or targeted sampling of 10 to 12 prostate samples is a urology examination performed in the outpatient department in order to confirm or exclude the suspicion of the presence of prostate cancer in male patients.

The examination is performed in the outpatient department with focus on minimizing the discomfort of each patient. The examination is done with the emphasis on intimacy and dignified manner using the latest technology.

 

Indications and examination procedure

If an urologist suspects a problem he can order the transrectal palpation of prostate and the PSA test (prostate specific antigen blood test). The PSA test can detect cancer at its early stage when the patient usually does not have any clinical problems. If the prostate cancer is diagnosed at an early stage it is highly treatable and can be completely removed.

Prostate biopsy is an examination that is performed in the outpatient department after the previous preparation (see preparation without performing prostate biopsy). The ultrasound rectal probe is inserted into the rectum of the patient being in a lateral position and having received local anaesthesia. After medical screening of the prostate and identifying possible suspect centres of the prostate tissue, a transrectal ultrasound and a targeted and systematic biopsy sampling of the prostate tissue are performed. Usually 10 to 12 samples are taken from both lobes of the prostate through a thin disposable needle.

Discomfort during examination can be reduced by the use of ENT analgesia method recommended by our specialists. Inhalation helps to ease tension and remove patient´s fear and significantly reduces his sensitivity during the examination.

The whole procedure takes about 10 to 15 minutes. After the examination, the patient can temporarily observe some blood in stools or minor bleeding from the rectum. He can even detect some blood in the urine and semen. These symptoms usually disappear within 24 hours. However, they can temporarily and suddenly appear several days after prostate biopsy.

The side effects of the examination may exceptionally include temperatures and febrile condition requiring hospitalization and administration of broad-spectrum antibiotics.

The results are usually known within 10 to 14 days. On the basis of these findings our specialists recommend therapy options to the patient - including suggested treatment and particular steps.

 

Instructions and preparation before prostate biopsy

Patient preparation

Before taking prostate samples and the examination itself, it is necessary to empty the rectum. Insert 1 to 2 glycerine suppositories into the rectum the evening before the examination (they are sold without a medical prescription by a pharmacist). Then insert one more glycerine suppository in the morning of the examination day. Please do not use any laxatives.

On the day of prostate biopsy you will get 2 tablets of antibiotics (or a medical prescription for them) from your urologist. You should take them on the day of the examination, at 7:00 a.m. and then 12 hours after the examination.

The patient should not take any medicines that interfere with blood clotting on the day of the examination and prior to it. These are mainly the following ones: Anopyrin, Warfarin, Godasal, Plavix, Clopidogrel and some others. In the case of their usage they should be discontinued or replaced by another medicine in a sufficient time prior to the examination.

 

Examination procedure:

  • The patient is in the left lateral position and the doctor carefully inserts an ultrasound probe (in size of a finger) into his rectum. The probe measures the size of the prostate and assesses the possible suspect areas.
  • Using a thin needle, the doctor takes several small samples (usually 10 to 14) of the prostate tissue.

The examination itself takes approximately 10 minutes. Patients consider the examination to be rather unpleasant than painful. It is recommended to undergo the whole examination while inhaling analgesia.

 

Possible complications and risks:

Due to the nature of the examination the most frequent complications are small and temporary bleeding from the rectum, blood in the urine or semen. Bleeding itself is usually not serious and will cease within few days. Very rarely (1.5 % of cases), the patient may observe more significant bleeding, difficulties with urination or temperatures.

In case you suspect some complications, contact us or the relevant urology department immediately.

It is recommended to schedule rest regime for 2 to 3 days to avoid greater physical activity, sexual intercourse and hot baths (only showers). During these days we recommend a higher fluid intake (3 to 4l a day).

In case of more serious health problems, such as urination discontinuance or high temperatures accompanied by chills it is necessary to go immediate to the urology outpatient department, where according to your condition an urologist may recommend a short-term hospitalization.