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Prostate Biopsy
What is
Prostate Biopsy?
A
prostate gland biopsy is a test to remove small
samples of prostate tissue to be examined under
a microscope.
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Effects
of Prostate Biopsy
A prostate
biopsy
is done to determine:
-
Whether a lump found in the prostate gland is
cancer.
The
cause of a high level of prostate-specific
antigen (PSA) in the blood.
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Candidates for Prostate Biopsy
A
biopsy may be done when a blood test shows a
high level of prostate-specific antigen (PSA) or
after a digital rectal examination finds an
abnormal prostate or a lump.
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Your Consultation
Tell your doctor if you:
·
Have had any bleeding problems.
·
Are allergic to any medications, including
anesthetics.
·
Take any medications regularly. Be sure your
doctor knows the names and doses of all your
medications.
·
Are taking any blood-thinning medications, such
as warfarin (Coumadin), heparin, enoxaparin (Lovenox),
aspirin, ibuprofen, or other
nonsteroidal
anti-inflammatory drugs (NSAIDs).
You will need to sign a consent form that says
you understand the risks of a prostate biopsy
and agree to have the biopsy done. Talk to your
health professional about any concerns you have
regarding the need for the biopsy, its risks,
how it will be done, or what the results will
indicate.
Before your prostate biopsy, you may be given
antibiotics to prevent
infection. You may be asked to take off all of
your clothes and put on a hospital gown.
Your skin at the biopsy site is cleaned with an
antiseptic solution, and the area around it is
covered with sterile cloth. Your doctor will
wear sterile gloves. It is very important that
you do not touch this sterile area.
Transrectal ultrasound (TRUS)
is commonly used to guide the placement of the
needle during a prostate biopsy.
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The
Prostate Biopsy Procedure
If a
prostate biopsy is done under local anesthesia
through the area between the anus and scrotum
(perineum), no other special preparation is
needed.
If the
biopsy is done through the rectum, you may need
to have an enema before the biopsy.
If the biopsy is done under general anesthesia,
do not eat or drink anything for 8 to 12 hours
before the biopsy. During preparation for the
biopsy, an intravenous line (IV) is inserted in
your arm, and a sedative medication is given
about an hour before the biopsy.
For a
prostate biopsy, a thin needle is inserted
through the rectum (transrectal biopsy), through
the urethra, or through the area between the
anus and scrotum (perineum). A transrectal
biopsy is the most common method used. The
tissue samples taken during the biopsy are
examined for cancer cells.
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Recovery
Call your doctor immediately if you:
·
Have heavy bleeding or bleeding
continues longer than 2 to 3 days.
·
Have increased pain.
·
Have a fever.
Are
unable to urinate within 8 hours or have blood
in the urine for longer than 2 to 3 days.
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Risks
A prostate biopsy has a slight risk of causing
problems such as:
·
Infection. This is more common in men who have
undiagnosed
prostatitis.
Usually, taking antibiotic medication before the
biopsy prevents an infection from developing.
·
Bleeding into the urethra or
bladder.
This can cause a blood blister (hematoma), an
inability to urinate, or a need to urinate
often.
·
Bleeding from the rectum. If you have had a
transrectal biopsy, you may experience a small
amount of bleeding from your rectum for 2 to 3
days after the biopsy.
·
An
allergic reaction
to the anesthetic medications used during the
biopsy.
Frequently Asked Questions
Q: Who performs the biopsy?
A:
This biopsy is done by a
surgeon
or a doctor who specializes in men's genital and
urinary problems (urologist)
in the doctor's office, a day surgery clinic, or
a hospital operating room.
Q: What happens during a transrectal biopsy?
A:
A transrectal biopsy takes about 30 minutes.
Several positions are possible for this method.
You may be asked to kneel, lie on your side, or
lie on your back with your feet resting in
stirrups. Your doctor may inject a local
anesthetic around the prostate gland before the
biopsy is taken.
Transrectal
ultrasound (TRUS) is generally used to
guide the needle
to the correct biopsy location. A prostate
biopsy is usually done with a spring-loaded
needle. The needle quickly enters the prostate
gland and removes a tissue sample.
The biopsy can also be done with a needle guide
attached to your doctor's finger. He or she
inserts the finger into the rectum. Then the
needle is slid along the guide, through the wall
of the rectum, and into the prostate gland. The
needle is turned to collect a tissue sample and
then pulled out.
Q:
What happens during a transurethral biopsy?
A:
A
transurethral biopsy usually takes about 30 to
45 minutes. For this method, you will lie on
your back with your feet resting in stirrups.
General or local anesthesia may be used. A
lighted scope (cystoscope)
is inserted into your urethra. It allows your
doctor to look directly at the prostate gland. A
cutting loop is passed through the cystoscope to
remove small pieces of prostate tissue.
Q: What happens during a transperineal biopsy?
A:
Transperineal biopsy is not done as commonly as
transrectal or transurethral biopsy. You will
lie on an examining table either on your side or
on your back with your knees bent. General or
local anesthesia may be used.
A small
incision is made in your perineum. Your doctor
inserts a finger into the rectum to hold the
prostate gland and then inserts the needle
through the incision and into the prostate
gland. To collect a sample of tissue, the needle
is gently turned and then pulled out. Biopsy
samples may be taken from several areas of the
prostate. Pressure is applied to stop the
bleeding, and a small bandage is placed over the
cut. The biopsy usually takes about 15 to 30
minutes.
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The following list of Urology procedures are
performed at Beverly Hills Medical Group -
please click the links to find out more:
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