It is important to know how the prostate biopsy is done, especially if you are a man over 50 who has an elevated risk for prostate cancer.
Your prostate doctor may recommend a prostate biopsy if they suspect that you have cancerous cells in your prostatic tissue.
If left untreated, these cells can lead to problems with bladder control and sexual function.
Prostate biopsies are typically performed outpatient under sedation or general anesthesia with the patient awake throughout the procedure.
What is a prostate biopsy?
A prostate biopsy is a test that doctors can do to find out if there is something wrong with the prostate. First, the doctor will ask you to pee in a cup, and then they will give you medicine to help your bladder empty. Next, the doctor will use a particular machine to take samples of tissue from your prostate gland.
During a prostate biopsy, doctors use a needle to take many samples of your prostate gland. The doctor who does this is called a urologist.
In the first tests, your urologist will see if you have prostate cancer. If they think that you might have it, they will do a biopsy.
They will take tissue samples from the prostate and look at them under a microscope to see any sign of cancer. They can also tell how quickly it’s likely to progress and what treatment options are best for you.
Why is a prostate biopsy done?
A prostate biopsy is a way to find out if you have cancer. Your urologist or doctor might recommend getting a biopsy if results show the following:
- A biopsy showed prostate cells that were not cancer.
- A PSA test shows that your levels are higher than average.
- You had a biopsy that came back normal, but you have elevated PSA levels.
- Your doctor finds lumps or other abnormalities. They do this by putting their fingers in your butt.
How to prepare for a prostate biopsy
Preparing for a rectal exam is easy. You have to do the following:
- Give a urine sample to find out if you have a urinary tract infection. If you have one, your prostate biopsy will be postponed for a while while you take antibiotics to get rid of it.
- You should stop taking any medication that can make you bleed more. This includes aspirin, ibuprofen, and some herbal supplements.
- Before your biopsy appointment, do a cleansing enema at home.
- You should take antibiotics before your prostate biopsy because this will help to prevent infection.
Types of prostate biopsy
A prostate biopsy can be collected in different ways. Yours might involve one of these:
- A needle is inserted through the rectum wall, through the back wall of your pelvis, and into your prostate gland. It’s then withdrawn without removing any tissue samples.
- The doctor inserts an instrument called a transrectal ultrasound probe into your rectum to guide a needle attached to it through the wall of your rectum and into your prostate gland. This procedure requires anesthesia because it can be painful otherwise.
What happens in a prostate biopsy?
You will need to lie down on your side. Then you will be asked to bring your knees up to your chest. Next, the doctor will apply gel and gently insert a thin probe into your rectum.
Transrectal ultrasonography uses sound waves to take pictures of your prostate. Your doctor will use these pictures to know where they need to give you an injection, which will make it less painful when they take the tissue sample. They also use images to guide the needle into place.
Once the area is numbed, there will be a device. There are lots of needles on it. The doctor will put them in your skin. It can make you feel uncomfortable for a second, but it is over quickly.
Your doctor might take a sample from your prostate to see what it is. Then, they will use an instrument called a biopsy gun to take the samples. It should only take about 20 minutes.
After a prostate biopsy, your doctor will tell you only to do light activities for 24 to 48 hours. After that, your doctor might recommend taking antibiotics for a few days.
Call your doctor right away if you experience the following:
- Difficulty peeing
- Lots of blood
- Worsening pain
What can happen after a prostate biopsy?
- Infection – Sometimes, when people have a biopsy on their prostate, they get an infection that needs to be treated with antibiotics.
- Blood in your pee – When people have a prostate biopsy, they may notice blood in their semen. It’s not a big deal. Blood from the biopsy might stay for a few weeks.
- Hard to pee – A prostate biopsy can make it difficult to pee after the procedure. Sometimes a temporary catheter needs to be put in because people can’t pee on their own.
- Blood in semen – Some people notice red or rust coloring in their semen after a prostate biopsy. This means there is blood, and it is ok. It may last for a few weeks after the biopsy.
Getting your results
The doctor who specializes in diagnosing cancer will look at the tissue samples taken from your prostate. The pathologist can tell if the tissue removed is cancerous.
If cancer is present, estimate how aggressive it is. Your doctor will explain this to you. And the report may contain the following:
- Description of the sample – Sometimes called the gross description, this report section is about the prostate tissue. It will tell you if it has any color or consistency.
- Cell description – Doctors may look at cells under the microscope to find out if they are cancerous. Sometimes, these cells do not have anything wrong with them and are called “prostatic intraepithelial neoplasia” or “atypical small acinar proliferation.”
- Cancer grade – If the pathologist finds cancer, it is graded with a score called Gleason. The score can range from 2 (low grade) to 10 (high grade), though the low range is not used often. Most Gleason scores for prostate biopsy range from 6 to 10. A score of 6 indicates low-grade prostate cancer, and a 7 shows medium-grade prostate cancer. Scores 8 or higher indicate high-grade cancers.
- Diagnosis – This section of the pathology report tells the doctor what the illness is and what they should do about it. It may also be where they can tell you if other tests are needed to find out more about this illness.
And that’s how the prostate biopsy is done.
Doctors recommend a prostate biopsy when there is something wrong with the prostate.
A prostate biopsy typically takes 20 minutes, and you may get an infection, blood in semen, or peeing may become difficult.
However, it’s a necessary procedure to rule out any cancer, and if positive, you can do something about it.
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