What You Need To Know About The Prostate Blood In Urine After Prostate Exam
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Dont Miss: Can Turp Spread Prostate Cancer
What Are Grade Groups
Grade Groups are a new way to grade prostate cancer to address some of the issues with the Gleason grading system.
As noted above, currently in practice the lowest Gleason score that is given is a 6, despite the Gleason grades ranging in theory from 2 to 10. This understandably leads some patients to think that their cancer on biopsy is in the middle of the grade scale. This can compound their worry about their diagnosis and make them more likely to feel that they need to be treated right away.
Another problem with the Gleason grading system is that the Gleason scores are often divided into only 3 groups . This is not accurate, since Gleason score 7 is made up of two grades , with the latter having a much worse prognosis. Similarly, Gleason scores of 9 or 10 have a worse prognosis than Gleason score 8.
To account for these differences, the Grade Groups range from 1 to 5 :
- Grade Group 1 = Gleason 6
- Grade Group 2 = Gleason 3+4=7
- Grade Group 3 = Gleason 4+3=7
- Grade Group 4 = Gleason 8
- Grade Group 5 = Gleason 9-10
Although eventually the Grade Group system may replace the Gleason system, the two systems are currently reported side-by-side.
How Long Does An Ultrasound Guided Prostate Biopsy Take
The ultrasound and biopsy procedure itself takes approximately 30 minutes.
The procedure together with preparation such the blood test, enema, injection of antibiotics, and observation time afterwards will take a couple of hours. If rectal bleeding occurs immediately after the procedure , you may be kept a little longer for observation until the radiologist or nurse feels that it is safe for you to go home.
Also Check: Prostate Cancer Spread To Pelvis
What Are The Risks
Infection: This can happen to one in 500 patients . We may give you antibiotics before or after your biopsy to reduce this risk but this is not always necessary. However, if you develop a fever, or have pain or a burning sensation passing urine, you might have an infection and should seek attention from your nearest A& E department.
Blood when you pass urine: This is not uncommon and can range from peachy coloured urine to rose or even claret coloured. It is rarely a sign of a serious problem. Increasing your fluid intake will usually help flush the system and clear any bleeding. However, if there is persistent or heavy bleeding every time you pass urine you should go to your nearest A& E department.
Difficulty passing urine: It is possible that the biopsy may cause an internal bruise or swelling that causes you difficulty passing urine. This can happen in less than 1 in every 200 cases and is more likely to happen in men who had difficulty passing urine before having the biopsy. Should you have difficulty passing urine, you may require a catheter and you will need to go to your nearest A& E department for assessment. A catheter is a hollow, flexible tube that drains urine from your bladder.
Allergic reaction: It is possible that you may have an allergic reaction to the medication we give you. Although the risk of this is low , you can reduce this risk by letting us know if you have had any previous allergic reactions to any medications or food.
Atypical Small Acinar Proliferation
Another type of abnormal finding is cells that look like they may be cancerous, but there are too few of them to make a cancer diagnosis. This is called atypical small acinar proliferation , or atypical glandular proliferation. To rule out prostate cancer, your urologist may recommend a repeat biopsy in a few months.
Also Check: Is Coffee Bad For Prostate
What To Expect After An Mri Fusion Transperineal Prostate Biopsy
- You will be able to go home on the same day following your procedure
- You may have some light bleeding in the perineal area, which is easily managed with gentle pressure
- You may feel some discomfort in the area for a day or two following the procedure
- Very rarely, the temporary inability to pass urine occurs this can be fixed by temporary placement of a urinary catheter.
Dont Miss: What Are The 4 Stages Of Prostate Cancer
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 such as warfarin or aspirin.
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 or nurse 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 .
The type of biopsy you will have depends on your hospital.
You May Like: Can Stress Affect Your Prostate
What Does It Mean To Have A Gleason Score Of 6 7 8 Or 9
Because grades 1 and 2 are not often used for biopsies, the lowest Gleason score of a cancer found on a prostate biopsy is 6. These cancers may be called well differentiated or low-grade and are likely to be less aggressive that is, they tend to grow and spread slowly.
Cancers with Gleason scores of 8 to 10 may be called poorly differentiated or high-grade. These cancers are likely to grow and spread more quickly, although a cancer with a Gleason score of 9-10 is twice as likely to grow and spread quickly as a cancer with a Gleason score of 8.
Cancers with a Gleason score of 7 can either be Gleason score 3+4=7 or Gleason score 4+3=7:
- Gleason score 3+4=7 tumors still have a good prognosis , although not as good as a Gleason score 6 tumor.
- A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor.
Questions To Ask Your Doctor Or Nurse
- Have I got high-grade PIN or ASAP?
- How much high-grade PIN or ASAP do I have?
- Do I need further tests to find out more?
- What is my risk of getting prostate cancer?
- How often will I need to have check-ups?
- What will my check-ups involve?
- Will I need to have another biopsy?
- Will I need any other tests?
Read Also: When Should Guys Get A Prostate Exam
Side Effects And Risks Of A Prostate Biopsy
Any invasive procedure carries risks and causes specific side effects.
One of the more common side effects post prostate biopsy is rectal bleeding. Rectal bleeding occurs since in most cases a transrectal prostate biopsy is used.
It means mild trauma of the rectum. This side effect would not occur in the case of transperineal prostate biopsy.
Blood in urine and increased risk of urinary tract infection are rare but possible complications. If a urinary tract infection occurs, doctors will prescribe antibiotics. Urinary tract infection post prostate biopsy is uncommon.
Some may also find difficulty while urinating, and doctors may need to insert a urinary catheter.
The Percent Core Volume Of Tissue Involved
Not only is the number of cores involved important, but the percent involvement of the core is important as well. The aggressiveness of the cancer is deemed differently if only 5% of the sample showed cancer versus 75%. This becomes important when seeing your eligibility for certain treatment options such as active surveillance.
Recommended Reading: How Long Recovery After Prostate Surgery
What Are The Advantages And Disadvantages Of Having A Biopsy
Your doctor should talk to you about the advantages and disadvantages of having a biopsy. If you have any concerns, discuss them with your doctor or specialist nurse before you decide whether to have a biopsy.
- Its the only way to find out for certain if you have cancer inside your prostate.
- It can help find out how aggressive any cancer might be in other words, how likely it is to spread.
- It can pick up a faster growing cancer at an early stage, when treatment may prevent the cancer from spreading to other parts of the body.
- If you have prostate cancer, it can help your doctor or nurse decide which treatment options may be suitable for you.
- If you have prostate cancer, youll usually need to have had a biopsy if you want to join a clinical trial in the future. This is because the researchers may need to know what your cancer was like when it was first diagnosed.
What Is A Transperineal Biopsy
This is where the doctor inserts the biopsy needle into the prostate through the skin between the testicles and the back passage .
A transperineal biopsy can be done under either general anaesthetic or local anaesthetic. If you have a biopsy under general anaesthetic, you will be asleep and wont feel anything. A general anaesthetic can cause side effects your doctor or nurse should explain these before you have your biopsy.
If you have a biopsy using a local anaesthetic, you are awake during the procedure and the anaesthetic numbs the prostate and the area around it.
The doctor will put an ultrasound probe into your back passage, using a gel to make this easier. An image of the prostate will appear on a screen, which will help the doctor to guide the biopsy needle.
There are two main types of transperineal biopsy you may have:
A targeted transperineal biopsy
This is where the doctor may just take a few samples from the area of the prostate that looked usual on the scan images from your MRI.
A template transperineal biopsy
This is where the doctor places a grid over the area of skin between the testicles and back package. They then insert the needle though holes in the grid, into the prostate. They might take up to 25 or more samples from different areas of the prostate. A template biopsy is sometimes used if a TRUS biopsy hasnt found any cancer, but the doctor still thinks there might be cancer.
Also Check: How Does Removing Your Prostate Affect You
What Happens During A Prostate Biopsy
Some of the effects you experience after a biopsy may depend on the type of biopsy you have. So, first, lets look at the different types of prostate biopsies.
There are three types of prostate biopsies doctors use to remove tissue samples from your prostate for lab analysis:
- transrectal biopsy
- transperineal biopsy
- transurethral biopsy
The surgeon will use an ultrasound tool to view the area around your prostate. Theyll also use a local anesthetic around the area to reduce pain. Guided by the ultrasound, the surgeon will use a needle to remove multiple tissue samples from your prostate gland.
In a transurethral biopsy, the surgeon uses a scope instead of an ultrasound. The scope goes through your urethra and has a tool to help the surgeon remove the tissue samples.
A prostate biopsy is a relatively low risk procedure. But there is some risk of adverse effects. These side effects are usually short-term and involve bleeding due to the needle or tools perforating the area around your prostate.
You may notice blood in your:
- rectum the first few days after your biopsy, and it may be difficult to stop the bleeding
- pee or poop for a few days, but this bleeding may extend up to a week or two
You may also have trouble peeing for a few days, especially after a transurethral biopsy. In some cases, the surgeon may insert a catheter to help you pee in the early stages of recovery.
Number Of Prostate Biopsy Cores Involved
During the biopsy, the urologist will have taken several samples, or cores, from the prostate. This was done with a prostate specialized device that went through the ultrasound probe and removed a small sample of the prostate tissue. This tissue comes out looking like a silk worm. The number of these cores that are positive will play into your disease risk.
The more the number of cores involved, the more concerning.
What Does It Mean If In Addition To Cancer My Biopsy Report Also Mentions Acute Inflammation Or Chronic Inflammation
Inflammation of the prostate is called prostatitis. Most cases of prostatitis reported on biopsy are not caused by infection and do not need to be treated. In some cases, inflammation may increase your PSA level, but it is not linked to prostate cancer. The finding of prostatitis on a biopsy of someone with prostate cancer does not affect their prognosis or the way the cancer is treated.
How To Make Your Prostate Biopsy Go Better
Before a prostate biopsy, discuss all thesteps you or your doctor can take to makethe experience as comfortable, safe, andinformative as possible.
Image: Wavebreakmedia Ltd/Getty Images
Here is what men need to know to minimize discomfort of a prostate biopsy and get the best results.
Many men choose to have prostate-specific antigen blood tests to check for hidden prostate cancer, despite the uncertain benefits. Having an abnormal PSA test result often leads to a prostate biopsythe only way to confirm the presence of cancer. Biopsies are invasive, but they have become routine.
To reduce discomfort and get the best results, discuss the procedure in detail with your doctor. Certain practices can improve the overall outcomefor example, make sure you get a shot of anesthetic into the prostate to numb pain during the procedure. “Local anesthesia makes a world of difference between having a tolerable biopsy experience and an unpleasant one,” says Dr. Marc B. Garnick, Gorman Brothers Professor of Medicine and a prostate cancer expert at Harvard-affiliated Beth Israel Deaconess Medical Center.
Recommended Reading: How To Hit A Guys Prostate
How To Read A Prostate Cancer Pathology Report
5 min read
If youve just received the results of a prostate pathology report from your doctor, you may have questions that you didnt think about when you first spoke with your doctor. While you can certainly always check back with your doctor for more clarification, well walk you through the information that is included in a prostate pathology report.
Preparing For Your Transperineal Biopsy
You usually have this test in the outpatient department under local anaesthetic. Sometimes, you may have it in the operating theatre under a general anaesthetic. This is when you are asleep and dont feel anything.
Your doctor will ask you to sign a consent form once you have all the information about the test.
You take antibiotics to stop an infection from developing after the biopsy. You take them before the biopsy and for a few days afterwards. Your doctor will explain when you need to take the antibiotics and for how long. This is usually for a couple of days afterwards.
You usually have a tube into your bladder to drain urine if you have a general anaesthetic. Your nurse removes the catheter on the day of surgery or the morning after.
Don’t Miss: Can Exercise Reduce Prostate Size
Is There An Alternative To A Prostate Biopsy
Prostate cancer enzyme tests A newer blood test is the 4Kscore test, which measures a persons risk of prostate cancer. This test does not completely replace the need for a biopsy, but it can help identify who should have one. As a result, it may help doctors reduce the number of people who have biopsies.
How To Get The Best Results
Most men do not find prostate biopsy excessively painful or uncomfortable, and the complications are usually not seriousbut can be. Certain steps taken before, during, and after the procedure can improve the outcome:
Take antibiotics. Taking preventive antibioticsbefore and after the procedurecuts the risk of infection substantially. Most infections are not dangerous but could become so if they get out of control. The overall chance of being hospitalized with an infection after prostate biopsy is 1% to 3%.
Review medications. Before the biopsy, your doctor may advise you to stop taking daily low-dose aspirin or an anticoagulant such as warfarin , dabigatran , edoxaban , rivaroxaban , or apixaban . These drugs reduce the bloods ability to clot. Your doctor will weigh the chance of bleeding against the need for anticoagulants to prevent heart problems or stroke.
Expect anesthesia. Get local anesthesia for the biopsy. This means an injection of a numbing drug into the prostate gland to reduce pain during the biopsy.