Transrectal ultrasound-guided biopsy
This procedure allows us to take tiny samples of your prostate tissue for microscopic analysis in the laboratory – which is the only definitive way to diagnose prostate cancer.
You will probably need a biopsy if you have had an abnormal PSA blood test (or rising PSA levels over time), suspicious rectal examination/PCA3 test or ultrasound scans. Repeat biopsies are necessary only if your PSA remains abnormally high or continues to rise.
We will give you a prescription for a course of antibiotic tablets to reduce the risk of infection, together with a full information sheet about the procedure and instructions on what to do if you have problems afterwards. You may be given further antibiotics at the time of biopsy.
Having explained the procedure to you and once you have signed your consent, our radiologist will insert the ultrasound probe gently into the rectum to scan your prostate. This may be a little uncomfortable but not painful. Local anaesthetic is then injected around the prostate gland; the prostate is measured and examined by ultrasound before the biopsies are taken using an automated needle.
The procedure should not be painful; most patients find it uncomfortable but generally tolerate it well. The process takes only a few minutes but you should allow for considerably more than this to take into account discussions with the radiologist and remaining in The Prostate Centre to rests until you feel ready to go; our nurses will want to check that you are able to pass water without any problem.
It’s important that you should know what to expect and you should therefore read carefully and keep the information you are given. We have comprehensive systems in place to ensure swift action if you do feel unwell in the days after your biopsy.
The analysis is fast-tracked by the laboratory and we usually know the outcome within 24-48 hours. The quickest way to give you the your results is for your consultant or one of our nurses to telephone you, but if you are concerned about receiving news in this way then please let us know and we can make alternative arrangements.
A copy of the histopathology report will be sent to you. These reports may be mystifying so we will interpret them for you at your next consultation; some patients want an in-depth analysis we can if you wish put you in touch with the pathologist to discuss your results.
Important: Occasionally, in spite of antibiotics, a prostate biopsy may result in infection. This can always be treated but may require intravenous antibiotics in hospital, so do let us or your doctor know urgently if you develop a temperature or the shakes after your biopsy.
In certain cases, it’s better to take the biopsies through the skin of the perineum (between the testicles and the anus) rather than through the rectum. This allows us to take many more samples (24 or more) and is therefore done under a light general anaesthetic, in hospital.