Encyclopedia

Prior to Procedure

You may be asked to do the following:

• Discontinue use of any blood-thinning medications, such as aspirin, ibuprofen, Ticlid, Aggrenox, or Coumadin for 4-7 days prior to the procedure.
• Begin taking an antibiotic as prescribed by your doctor. You will continue taking the antibiotic after the procedure as well.
• Self-administer a fleet enema several hours prior to the biopsy procedure.

Anesthesia

In general, a transrectal prostate biopsy does not require anesthesia. If your doctor obtains a biopsy through the urethra or perineum (see below), you may be given local or general anesthesia.

Description of the Procedure

Your doctor will use one of the following methods to perform the biopsy:

• Transurethral biopsy—You will lie on your back and your doctor will insert a lighted cystoscope (flexible tube) through your penis into the urethra. The urethra is the tube that carries urine from the bladder. Your doctor will obtain the biopsy with a cutting loop passed through the cystoscope (rare).
• Perineal biopsy—Lying on your side or back, your doctor will make a small incision in the perineum. The perineum is the area between the scrotum and the rectum. He or she will insert a small needle through the incision into the prostate gland to obtain the biopsy. This method is not as commonly used as other methods.
• Transrectal biopsy—This is the most common type of prostate biopsy. You will lie on your left side on an exam table. Your doctor will insert a small lubricated cylindrical ultrasound device—called a transrectal ultrasound, or TRUS—into your rectum. This device will emit sound waves to produce an image of your prostate. These images will help guide placement of the biopsy needle. Your doctor will then insert the tiny biopsy needle through the wall of your rectum and into the prostate gland. Because tumors can occur anywhere in the prostate, your doctor may take several biopsies from different areas of the prostate.

After the Procedure

You may experience some mild discomfort and soreness in the area of the biopsy. You may also see blood in your urine, stool, or ejaculate for several days after the procedure.

How Long Will It Take?

In general, this procedure is usually completed within 30 minutes.

Will It Hurt?

You will feel pressure in the rectum as the ultrasound probe is guided into place. In addition, you will feel a brief, sharp pain as the needle is inserted into the prostate gland to obtain the biopsy.

Possible Complications

In general, there are few complications associated with this procedure. However, you may experience the following:

• Infection
• Bruising at the biopsy site
• Prolonged bleeding at the biopsy site
• Difficulty urinating

Average Hospital Stay

You will not be required to stay in the hospital.

Postoperative Care

Your doctor may recommend that you do the following after the procedure:

• Avoid strenuous activity the day and evening of the procedure.
• Do not take blood-thinning medication for at least two days after the procedure, and until any blood in the urine is clear.
• Keep well-hydrated by drinking plenty of fluids for the next few days after the procedure.