What Does A Prostate Biopsy Involve
If you decide to have a biopsy, youll either be given an appointment to come back to the hospital at a later date or offered the biopsy straight away.
Before the biopsy you should tell your doctor or nurse if youre taking any medicines, particularly antibiotics or medicines that thin the blood.
You may be given some antibiotics to take before your biopsy, either as tablets or an injection, to help prevent infection. You might also be given some antibiotic tablets to take at home after your biopsy. Its important to take them all so that they work properly.
A doctor, nurse or radiologist will do the biopsy. There are two main types of biopsy:
- a trans-rectal ultrasound guided biopsy, where the needle goes through the wall of the back passage
- a transperineal biopsy, where the needle goes through the skin between the testicles and the back passage .
Prostate Biopsy Specimens: Ask For Meticulous Labeling
The way that prostate biopsy samples are handled varies among hospitals. The samples, or “cores,” are put onto glass slides to be examined under a microscope for signs of cancer. Find out if the physician doing the biopsy will place each core in a separate, labeled container. If cancer is discovered, its location in the prostate gland can affect decisions about further testing and possible treatment.
Individual labeling of biopsy cores is more expensive, and not all hospitals provide this level of service. “If all of the samples from the right and left side of the prostate gland are processed together, as opposed to individually, consider having the biopsy done elsewhere,” Dr. Garnick says.
Lymph Node Biopsy As A Separate Procedure
A lymph node biopsy is rarely done as a separate procedure. Its sometimes used when a radical prostatectomy isnt planned , but when its still important to know if the lymph nodes contain cancer.
Most often, this is done as a needle biopsy. To do this, the doctor uses an image to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.
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Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
What Happens After A Prostate Biopsy
Your recovery process will vary depending on the type of anesthesia that isused. If you were given general anesthesia, you will be taken to a recoveryroom for observation. Once your blood pressure, pulse, and breathing arestable and you are alert, you will be taken to your hospital room ordischarged to your home.
If local anesthetic was used, you may go back to your normal activities anddiet unless otherwise instructed. You may feel the urge to urinate or havea bowel movement after the biopsy. This feeling should pass after a fewhours.
There may be blood in your urine or stool for a few days after the biopsy.This is common. Blood, either red or reddish brown, may also be in yourejaculate for a few weeks after the biopsy. This, too, is normal.
The biopsy site may be tender or sore for several days after the biopsy.Take a pain reliever for soreness as recommended by your healthcareprovider. Aspirin or certain other pain medicines may increase the chanceof bleeding, so be sure to take only recommended medicines.
Increase in the amount of blood in your urine or stool
Belly or pelvic pain
Changes in the way your urine looks or smells or burning with urination
Fever and/or chills
Your healthcare provider may give you other instruction, depending on yoursituation.
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Set To Experience Biopsy
The little reproductive organs behind the prostate will be assessed and the area amongst it and the prostate will be infused one on every side with anesthesia, to numb it. The biopsy will be performed then, by taking specimens of your prostate tissues and putting these examples under the magnifying instrument to search for tumor cells.
What Does The Equipment Look Like
Ultrasound scanners consist of a console containing a computer and electronics, a video display screen and a transducer or probe that is used to do the scanning. The transducer sends out inaudible high frequency sound waves into the body and then listens for the returning echoes. The principles are similar to sonar used by boats and submarines.
The ultrasound image is displayed on a video screen that looks like a computer or television monitor. The resulting image is based on the amplitude and frequency of the signal. The ultrasound image makes an image taking into account signal travel time, tissue composition, and type of body structure through which the sound travels.
The ultrasound probe used in prostate biopsies is about the size of a finger. Once the probe is placed in the rectum, the biopsy is performed with a spring-driven needle core biopsy device, or biopsy gun. The handheld device includes a long but very thin needle specially designed to open inside the prostate, take the sample and then close.
The traditional MRI unit is a large cylinder-shaped tube surrounded by a circular magnet. You will lie on a table that slides into the center of the magnet.
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Prostate Biopsy Side Effects Are Common
Complications from prostate biopsies are common but usually not severe, a study in Urology reveals. Participants in the study had biopsies to look for cancer after an abnormal rectal exam or prostate-specific antigen blood test. In a biopsy, a fine needle punches quickly through the rectal wall to remove a tiny sample of prostate tissue for examination under a microscope. Doctors took 12, 18, or 24 samples per participant. Typical problems from biopsy include pain, soreness, and infections. A more serious complication, which may lead to hospital admission, is acute urinary retention, in which a man is temporarily unable to drain his bladder.
Here is what the study found:
40% of the men experienced a complication.
The complication rate was as high as 57% in men with 24-sample biopsies.
Only 1.2% of the men required hospital admission.
9.1% ended up visiting an emergency room.
6.7% developed acute urinary retention.
Prostate needle biopsy is the only way to diagnose prostate cancer, regardless of PSA test results. The complication rate would vary with the general health of the men involved.
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Signs And Symptoms Of Prostate Cancer
What kind of anesthesia is used for prostate biopsy?
Are you put to sleep for a prostate biopsy?
How painful is a prostate biopsy?
How long does a prostate biopsy take?
Signs and symptoms of prostate cancer
Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as:
- Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
- Blood in the urine or semen
- Trouble getting an erection
- Pain in the hips, back , chest , or other areas from cancer that has spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord
Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia , a non-cancerous growth of the prostate. Still, its important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.
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Biopsy For Prostate Cancer
In this summary men we interviewed describe their experiences of biopsies. If the initial tests show the possibility of cancer, men are usually asked to have a biopsy, in which a sample of cells is taken from the prostate to be looked at under the microscope. The biopsy is usually done through the back passage , but occasionally it can be taken through the skin behind your testicles or while you are having a cystoscopy examination .Men we interviewed who had biopsies had very different experiences. Most reported that the biopsy was uncomfortable, but not painful. One man said that it was no more uncomfortable than having a blood sample taken, and others thought the description of a biopsy as ‘being flicked with an elastic band’, was a good description. One man found the procedure more embarrassing than painful and another man said that his privacy and dignity were not always respected.
Comparison Of Satisfaction With Procedure And Willingness To Repeat Biopsy Procedure And Incidence Of Complications Between Groups
The results of this study revealed that there was no statistical difference in the level of satisfaction experienced by the participants of either groups. This was in contrast to the report by Na Wang and colleagues . In their study of 190 men, over half in the CB group while only 24.2% of the men in PPNB+IRLA group reported excellent satisfaction with the procedure . However, the difference in proportion was less pronounced when the sum of men who reported either excellent or good levels of satisfaction were compared between the groups: 84.7% versus 75.8% for CB and PPNB+IRLA, respectively.
The willingness to repeat the prostate biopsy using the same method of analgesia was similar across the groups. Obi et al. reported similar proportions of men willing to have a repeat biopsy 72% of the men who had PPNB and 88% men who had saddle block were willing to have a repeat prostate biopsy .
The results showed a low incidence of complications, with no significant difference between the groups. This was similar to the findings by Na Wang et al. where out of 95 persons per group, one man, 2 men and 6 men had hematuria, fever and urinary retention, respectively in the CB group, while 3 men, 4 men and 4 men with similar complications, respectively, in the PPNB+IRLA group. Similarly, there was no significant difference in the incidence of complications between the groups in the study by Urabe et al. .
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Sex After Prostate Surgery And Achieving Orgasm
Sex after prostatectomy is an important concern for most men. The total removal of the cancerous tissues is the primary goal, but the quality of life after prostate surgery is also important. Worrying about ED makes men be nervous and anxious when thinking about undergoing radical prostatectomy.
However, whilst most patients focus on erectile dysfunction, orgasm is somehow under-considered. But is it possible to achieve orgasm after prostatectomy? Erections and orgasm are equally important for a healthy sex life.
The good news is that sex after prostate surgery is very possible and enjoyable for most men. This is due to the newest robotic technologies that are nerve-sparing and preserve the sexual function.
Dr. Samadis robotic prostate surgery, SMART Surgery, was explicitly designed to spare the tiny nerve bundles surrounding the prostate in order to preserve sexual potency.
Men who undergo Dr. Samadis robotic prostate surgery have a reasonable chance of regaining complete erectile function for sex after prostate surgery.
Why Do I Need A Prostate Biopsy
A prostate biopsy is the only reliable method to detect prostate cancer. If your PSA is elevated and/or if your prostate exam is abnormal then a prostate biopsy is required to assess whether you have a prostate cancer. There are urine tests and imaging studies such as MRI that can aid in screening for prostate cancer, but these are not diagnostic.
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How Painful Is A Prostate Biopsy
The most common complications of prostate biopsy are Pain in the area between the anus and scrotum for a few days to a week and Blood in your urine for a few days to several weeks. You will feel some pressure when the probe is inserted, but it is usually not painful. Usually between 6 12 prostatic tissue samples are obtained and the entire procedure lasts about 10 minutes. A local anesthetic can be used to numb the area and reduce any pain. Most men do not find prostate biopsy excessively painful or uncomfortable, and the complications are usually not serious.
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What Are Some Common Uses Of The Procedure
A prostate biopsy is currently the only way to definitively diagnose prostate cancer. It also helps differentiate cancer from benign prostatic hyperplasia or nodular enlargement of the prostate, a very common condition in middle-aged and older men that requires a different treatment approach than that of cancer.
A prostate biopsy may be ordered if the physician detects a nodule or other abnormality on the prostate during a digital rectal examination , a common prostate cancer screening test.
A biopsy also may be ordered when a blood test reveals elevated levels of prostate-specific antigen. While there are several reasons for an elevated PSA level, higher PSA levels are sometimes associated with cancer. PSA trends over time may trigger your physician to order a biopsy.
MRI-guided prostate biopsy may be used in patients who have a rising PSA level yet a negative ultrasound-guided biopsy. It also may be used in situations where a diagnostic prostate MRI performed due to rising PSA demonstrates a very small abnormality that may not be easily targeted by ultrasound. MRI is also useful in patients who have previously undergone a biopsy and want to improve the sensitivity of the procedure and the precision of the biopsy.
A biopsy not only detects cancer it also provides information on the aggressiveness of the cancer and helps to guide treatment decisions.
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How Will Treatment Affect My Libido
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect your libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. Hormone therapy can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
2013 study , about 3 percent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
If youre concerned about this side effect, ask your doctor about taking a drug for an erectile dysfunction , such as Cialis or Viagra. The increased blood flow from these drugs may help prevent your penis from getting smaller. Theyll also help with acquiring and maintaining an erection.
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What Is A Prostate Biopsy
The prostate gland is found only in males. It sits below the bladder andwraps around the urethra . Theprostate helps make semen.
A biopsy is a procedure used to remove a small piece of tissue or cellsfrom the body so it can be examined under a microscope.
In a prostate biopsy, prostate gland tissue is taken out with a biopsyneedle or during surgery. The tissue is checked to see if there are canceror other abnormal cells in the prostate gland.
A prostate biopsy may be done in several different ways:
Transrectal method. This is done through the rectum and is the most common.
Perineal method. This is done through the skin between the scrotum and the rectum.
Transurethral method. This is done through the urethra using a cystoscope .
Ultrasound is usually used to look at the prostate gland and guide thebiopsy needle.
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What Abnormal Results Mean
A positive biopsy result means that cancer cells have been found. The lab will give the cells a grade called a Gleason score. This helps predict how fast the cancer will grow. Your doctor will talk to you about your treatment options.
The biopsy may also show cells that look abnormal, but may or may not be cancer. Your provider will talk with you about what steps to take. You may need another biopsy.
What The Studies Say
In a Finnish survey about prostate biopsies and the need for rebiopsy, 18% of men said they would not accept a new biopsy, and the leading cause was pain. This symptom is sometimes as severe as causing tension and anxiety in men. Many of them end up with an unfavorable attitude to the procedure. Others are adequately treated or maintain close contact with the doctor reporting their symptoms and adjusting the doses. When patients achieve relief, they are more likely to accept a new biopsy if needed in the future.
Pain measurement studies in prostate biopsy use different methods to assess pain. The most common is a scale from 0 to 10, known as the visual analog scale. Other instruments can simply measure the respiratory rate, serum cortisol levels, or blood pressure. According to these studies, when patients feel very anxious, their perception of pain increases. Thus, the more nervous the patient is, the higher the need for anesthesia.
However, most studies mentioned above evaluate pain during the procedure and shortly after. As noted above, feeling pain is natural after any surgical procedure and not an alarming sign at all. Pain should go away after a few days or one week, and it is easier to manage as the days go by. If you still have significant pain symptoms one or two weeks after a prostate biopsy, it will be a good idea to talk to your doctor. You might have a complication -usually an infection- that is not allowing for a complete recovery.
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