Prostate Biopsy Procedure

(Prostate Gland Biopsy, Transrectal Prostate Biopsy, Fine Needle Biopsy of the Prostate, Core Biopsy of the Prostate)

Procedure Overview

What is a prostate biopsy?

A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. A prostate biopsy is a procedure in which prostate gland tissue samples are removed with a special biopsy needle or during surgery to determine if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.

A prostate biopsy may be performed in several different ways:

  • transrectal method - through the rectum (this is the most common)

  • perineal method - through the skin between the scrotum and the rectum

  • transurethral method - through the urethra using a cystoscope (a flexible tube and viewing device)

Another procedure that may be used to evaluate the prostate gland is a prostate/rectal sonogram. Please see this procedure for additional information.

What is the prostate gland?

The prostate gland is about the size of a walnut and surrounds the neck of a man’s bladder and urethra - the tube that carries urine from the bladder. It is partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It is made up of three lobes: a center lobe with one lobe on each side.

As part of the male reproductive system, the prostate gland’s primary function is to secrete a slightly alkaline fluid that forms part of the seminal fluid (semen), a fluid that carries sperm. During male climax (orgasm), the muscular glands of the prostate help to propel the prostate fluid, in addition to sperm that was produced in the testicles, into the urethra. The semen then travels through the tip of the penis during ejaculation.

Reasons for the Procedure

A prostate biopsy is performed after other diagnostic tests indicate a problem with the prostate gland. The most common tests are:

  • digital rectal examination (DRE) - the physician places a gloved, lubricated finger into the rectum to feel the prostate and check for any abnormalities

  • prostate-specific antigen (PSA) - a blood test that may suggest the presence of prostate cancer

  • transrectal ultrasound (TRUS) - a test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions like gland enlargement, nodules, or tumors

A prostate biopsy may be performed to diagnose prostate cancer and to determine the cause of an enlarged prostate gland.

There may be other reasons for your physician to recommend a prostate biopsy.

Risks of the Procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

  • bruising and discomfort at the biopsy site

  • prolonged bleeding from the biopsy site

  • infection near the biopsy site

  • difficulty urinating

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Before the Procedure

  • Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.

  • You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.

  • Notify your physician if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).

  • Notify your physician of all medications (prescription and over-the-counter) and herbal supplements that you are taking.

  • Notify your physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

  • Generally, no prior preparation, such as fasting or sedation, is required for the transrectal or perineal method. If the transurethral method is to be used, general anesthesia may be used. If you are to have general anesthesia, you may be instructed to fast before the procedure, generally after midnight. Your physician will give you specific instructions.

  • If your physician uses the transrectal method, you may have an enema the night before or the morning of the biopsy.

  • You may receive a sedative prior to the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home. This is most likely if your physician is using the transurethral method.

  • Based upon your medical condition, your physician may request other specific preparation.



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