What is the prostate cancer biopsy?

Your internist or family doctor or community clinic will have recommended you for a prostate biopsy, if prostate cancer is suspected.  A urologist will likely be the clinician who performs your biopsy.  You may hear this called a transrectal ultra sound (TRUS) guided prostate needle biopsy.

TRUS guided prostate needle biopsy

A prostate biopsy involves taking small pieces of prostate tissue to be looked at more closely under the microscope. The aim of a biopsy is to detect prostate cancer that has the potential to cause symptoms or affect your life expectancy.

Your urologist should talk to you about the advantages and disadvantages of having a biopsy and discuss any concerns you may have before you decide whether or not to have the test, before the test is performed.

If you decide to have a biopsy you should be given written information about the procedure and what it involves.

What does a biopsy involve?

If you decide to have a biopsy, you may be given an appointment to come back to the hospital at a later date or you may be offered a biopsy straight away.

The biopsy involves taking around ten to 15 small samples of tissue from the prostate. If you have a bigger prostate you may have more samples taken. You should be told how many to expect. A trans rectal ultrasound scan (TRUS) is carried out at the same time and helps the urologist to guide the biopsy needles and measure the size of the prostate gland.

Before the biopsy you should tell your doctor or nurse if you are taking any medicines, particularly drugs to prevent blood clots (anti-coagulants), including warfarin, aspirin or clopidogrel.

About half an hour before your biopsy you will be given antibiotic tablets or an antibiotic injection to help prevent infection. You will need to continue your course of antibiotics when you go home. After the biopsy you may also be given an antibiotic suppository in your rectum .

The ultrasound probe is lubricated with gel and passed into your back passage (rectum), as shown below. The probe is the size of a fat finger. Some men find this a little uncomfortable. You should also be given a local anaesthetic injection into the prostate to help reduce any discomfort when the biopsy samples are taken. The needle is then placed down the shaft of the probe and is passed through the wall of the back passage into the prostate gland, under the guidance of the ultrasound image.

You may feel a short sharp sensation each time the needle goes in. Each man is different and while some describe the biopsy as painful, others have only slight discomfort. The biopsy will take 10 to 15 minutes. You may be asked to wait for about half an hour after the biopsy or until you have passed urine before going home.

What are the possible side effects of biopsy?

Short-term bleeding

Once you have gone home, you may see blood in your urine or bowel motions for up to two weeks. You may find blood in your semen for up to six weeks. If it takes longer than this to clear up, or gets worse after a period of recovery, you should see a doctor straight away.

Urine retention

Some men are unable to pass urine after a biopsy. This is called urine retention. If this happens to you i