What is a prostate biopsy?
A prostate biopsy involves taking a sample of tissue from the prostate, then examining it under a microscope to find out if it contains any cancer cells. It is used to detect or rule out prostate cancer. The tissue sample is assessed by a pathologist. At present, there is no other way of confirming or ruling out a diagnosis of prostate cancer.
When should a biopsy of the prostate be performed?
Whenever a lump on the prostate is discovered during a digital rectal examination. A prostate biopsy should also be performed if the level of PSA in the blood is higher than normal and other factors that can cause it to be raised (e.g. inflammation, cycling, sexual intercourse or a medical examination of the rectum) have been excluded.
A prostate biopsy should also be carried out where imaging procedures, particularly mpMRI, suggest possible cancer.
How is a prostate biopsy performed?
A prostate biopsy is an outpatient procedure carried out under local anaesthetic at your urologist's office or hospital urology department.
The biopsy is taken either via the rectum or via the perineum. Transrectal ultrasound (ultrasound using an ultrasound probe inserted into the rectum) is used to help guide the biopsy needle to the correct location.
To reduce the risk of a prostate or urinary tract infection, you should take antibiotic tablets for 3 days after the procedure. Alternatively, you may be given a one-off dose of antibiotics shortly before the procedure.
The surgeon will usually take 10–12 samples, but may take significantly more for repeat biopsies or where the prostate is enlarged. Following assessment of the samples under a microscope by a pathologist, biopsy results are usually available within 3–4 working days.
What are the risks of a prostate biopsy?
After the biopsy, there may be some blood in your urine or slight bleeding from the rectum. This usually stops by itself. If this bleeding does not stop, you should contact your urologist immediately or go to a hospital urology department.
Urinary tract infection or epididymitis can also occur, even where antibiotics are given to reduce this risk. The most common symptoms are a burning sensation when passing water, frequent urination or pain in the testicles. If you come down with a fever you should contact your urologist without delay. A further rare complication is painful urinary retention (where you are unable to pass water). If this happens, you should go to your urologist or a hospital urology department immediately.
The scientific consensus at present is that a biopsy does not increase the risk of cancer cells being spread to other parts of the body.
Are there any alternatives to conventional prostate biopsy?
As an alternative to conventional transrectal biopsy, our clinic also offers the option of MRI-TRUS fusion biopsy. You can find more information on MRI-TRUS fusion biopsy on the following web pages: