PROSTATE NEEDLE BIOPSY

A prostate biopsy usually takes less than 5 minutes to perform.

You will be asked to lie on the exam table on your left side with your knees pulled up for the procedure.

An anesthetic gel is placed in the rectum, an anesthetic is injected into the surface of the prostate and IV sedation is available for comfort.

A prostate ultrasound uses an ultrasound probe inserted through the rectum. This probe generates high frequency sound waves to create a picture of the prostate.

Biopsies of your prostate are done with a small needle inserted through the ultrasound probe, which is used to guide the location of the biopsy needle. Each biopsy takes a small core of tissue from the prostate. Typically, 12 cores are taken, but your doctor may recommend additional samples be taken based on your anatomy or condition.

Your doctor will discuss the ultrasound findings with you after the procedure, but the results of the biopsy typically take one week to return.

Risks of Prostate Biopsy:

Infection

An antibiotic is given by mouth the day of the procedure and for 2 days after the procedure to minimize this risk. Please let your doctor know if you have any allergies or drug intolerances, or if you have any artificial implants or heart valve disease. Please let your doctor know if you get any symptoms of infection after the biopsy such as fever, persistent blood in the urine, persistent discomfort, unusual frequency, cloudy, odorous urine or an inability to urinate. These symptoms are unusual.

Bleeding

Typically, a small amount of blood is seen in the urine or bowel movements for 24 hours after biopsy. You should expect to see red or brown discoloration to the ejaculate for up to a month after your biopsy. Please clarify with your doctor if you use aspirin, Vitamin E, or any prescription blood thinners before your biopsy to minimize the risk of bleeding, and how far in advance you should hold these medications.

Discomfort

An anesthetic gel may be placed in the rectum before biopsy to minimize discomfort. An anesthetic is injected into the surface of the prostate as well. You may also ask for a mild sedative for the procedure if desired. If a sedative is given, you will need to arrange for a ride home and will have activity restrictions for 12 hours. If a sedative is used, you may also be asked not to eat or drink for 4 hours before the biopsy. A small amount of voiding discomfort is common for 24 hours after biopsy.

Difficulty Voiding

Problems emptying the bladder after biopsy are very rare. If difficulty emptying occurs, it is usually temporary, but a catheter may be required until the difficulty emptying resolves.

Injury to the Prostate or Nearby Structures

Injuries to the urethra, bladder, bowel, rectum, prostate or other organs or blood vessels; scarring, fistulas between the urinary system, bowels, or skin are extremely rare. To minimize this risk, you will be asked to do an enema at home 3 hours before arrival to clear the rectum of stool. This allows for a clear picture of the prostate by the ultrasound. If the ultrasound cannot clearly image your prostate, your doctor will stop the procedure for your safety and ask you to return on another date.

Alternatives to Prostate Biopsy: Further radiological studies, further blood or urine tests or continued observation of symptoms and/or test results. These studies may not be able to give the same information that a biopsy can provide.

While a prostate ultrasound and prostate biopsy are often effective tests, not all cases of prostate cancer or other prostate problems can be diagnosed with this test. It is very rare for the results to report a problem that is not present (false positive), but prostate biopsy has a small likelihood of not detecting a problem that is present (false negative). You may request a second opinion on your results.

INSTRUCTIONS FOR AFTER YOUR PROSTATE BIOPSY

• Drink plenty of water and avoid exertion for the rest of the day.
• You may notice some discomfort in the rectal area. This is normal.
• It is also normal to see some blood with occasional clots in your urine or stool for several days.
• You may notice some blood in your ejaculate for 3-4 weeks. This is normal.