Definition and Overview
Prostate biopsy is a diagnostic exam that is commonly used to confirm the presence of prostate cancer. It involves obtaining tissue samples of the prostate glands for close examination.
The prostate gland is part of a male’s urinary system. It sits close to the bladder and surrounds a portion of the urethra, which connects the bladder and the kidneys. It also belongs to the male’s reproductive system since it supports semen reproduction.
The prostate undergoes changes and it can grow significantly as man ages. At 60 years old, a man’s prostate can become so large that it can push itself against the urethra, blocking the flow of urine in the process. It also becomes prone to cancerous cells. If cancer is suspected, a tissue sample will be obtained through a biopsy that can confirm the presence of cancer.
Who should undergo and expected results
There are usually two major reasons why a urologist, a doctor who specializes in the urinary system and the male’s reproductive system, request for a prostate biopsy.
One, the urologist suspects the symptoms point to cancer. These include difficulty in urination, blood in semen or urine, burning sensation during urination, pain in the thighs or the lower back, and erectile dysfunction. The biopsy may also be used to rule out other prostate-related diseases that have similar symptoms like prostatitis or inflammation of the prostate.
Second, the results of the prostate-specific antigen (PSA) test reveal certain abnormalities. PSA is a blood test that measures the amount of prostate proteins in the body and is sometimes taken as part of routine cancer screening among men, particularly those who are considered high-risk, such as those who are 60 and older, African-American, obese, and with a family history of the disease.
Abnormalities in the PSA reading don’t always mean cancer. In some cases, for example, they indicate benign tumors. A biopsy is conducted to confirm if the tumors are benign or malignant before a treatment plan is designed for the patient.
How the procedure works
Prior to conducting the biopsy, the urologist will explain the procedure in detail to the patient who will have to sign a form signifying that he is consenting to the procedure. Details that will be covered include the benefits, risks, and possible complications of the biopsy.
The patient’s vital signs will then be checked before he is ushered to the lab where he removes all his clothes and changes to a lab gown. He is then provided with a local or general anesthetic as well as antibiotics to minimize the risk of infection.
In a biopsy, a needle is used to collect tissue samples. There are three ways to do it: through the rectum (transrectal), through the skin in between the scrotum and anus, or through the penis passing through the urethra. In a transrectal biopsy, the patient will undergo an enema to clear the bowel and the procedure will be performed using an ultrasound for guidance. A biopsy needle is then inserted to collect at least 10 to 12 tissue samples.
The entire procedure takes just 15 minutes to complete and the results will be available within a week.
Possible risks and complications
After the biopsy, it’s normal for the patient to feel slight discomfort and bleeding. However, if the latter continues for more than a day, the patient is advised to seek medical help right away. Also, although antibiotics are provided before the procedure, infection may still occur, especially if the patient has prostatitis.
There’s also the possibility that the results are inconclusive, which means it’s not clear whether the patient has cancer or not. This could be because there’s not enough tissue samples collected to confirm it. In such case, the doctor may either request for another biopsy or wait for further symptoms to appear. The accuracy of the results can also be a potential risk as they could be false-positive, which could force the patient to undergo unnecessary tests and treatment, or false-negative, which may prevent the doctor from treating cancer promptly.
Aliotta PJ, Fowler GC. Prostate and seminal vesicle ultrasonography and biopsy. In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler’s Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 121.
American Cancer Society. How Is Prostate Cancer Diagnosed? Updated 3/12/21015. http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-diagnosis. Accessed 9/1/2015.
Trabulsi EJ, Halpern EJ, Gomella LG. Ultrasonography and Biopsy of the prostate. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 97.
What is Prostate Biopsy: Overview, Benefits, and Expected Results
Prostate biopsy is a medical procedure used to diagnose prostate cancer or other prostate conditions. It involves taking small samples of tissue from the prostate gland to be examined under a microscope. This article will provide you with a comprehensive overview of prostate biopsy, its benefits, and the expected results.
1. Understanding Prostate Biopsy:
Prostate biopsy is a crucial tool in the diagnosis of prostate cancer. It is recommended when other tests, such as a prostate-specific antigen (PSA) blood test or a digital rectal exam (DRE), raise concerns about the possibility of prostate cancer. The samples taken during a prostate biopsy are then examined by a pathologist to determine if cancer is present or if there are other abnormalities in the prostate gland.
2. Types of Prostate Biopsy:
There are two main methods of performing a prostate biopsy:
a) Transrectal Ultrasound (TRUS) Guided Biopsy: This is the most common type of biopsy. It involves using a probe inserted into the rectum to visualize the prostate gland. The doctor then uses the ultrasound images to guide the biopsy needle into specific areas of the prostate for tissue sampling.
b) Transperineal Biopsy: This method involves accessing the prostate through the perineum, the area between the scrotum and the anus. The doctor uses ultrasound guidance or an MRI to place the biopsy needle into the prostate. This technique may be used if previous biopsy results were inconclusive or if a targeted biopsy is required.
3. Benefits of Prostate Biopsy:
Prostate biopsy is essential for accurate diagnosis and treatment of prostate cancer. Here are some of the key benefits:
a) Early Detection: Prostate biopsy can detect cancer at an early stage, allowing for timely intervention and improved treatment outcomes.
b) Accurate Diagnosis: Prostate biopsy provides the most accurate diagnosis of prostate cancer by examining actual tissue samples.
c) Risk Stratification: The biopsy results help determine the aggressiveness and stage of prostate cancer, aiding in personalized treatment planning.
d) Monitoring Progression: Biopsy results can be used to monitor the progression of prostate cancer and assess the effectiveness of treatment over time.
4. Expected Results of Prostate Biopsy:
When you undergo a prostate biopsy, you can expect the following results:
a) Negative Biopsy: A negative biopsy result means that no cancer cells were detected in the samples taken from your prostate gland. However, it is important to note that a negative biopsy does not completely rule out the presence of cancer.
b) Positive Biopsy: A positive biopsy result indicates the presence of cancer cells in the prostate gland. The biopsy may also reveal information about the aggressiveness and stage of the cancer, which helps determine the appropriate treatment plan.
c) Inconclusive Biopsy: In some cases, the biopsy results may be inconclusive, meaning that the samples do not provide clear information about the presence or absence of cancer. In such cases, further tests or a repeat biopsy may be necessary.
d) Complications: While rare, complications such as bleeding, infection, or difficulty urinating may occur after a prostate biopsy. It is important to follow your doctor’s post-biopsy instructions and report any unusual symptoms.
5. Prostate Biopsy Procedure:
Here is a step-by-step overview of what to expect during a prostate biopsy:
a) Preparing for the Biopsy: Your doctor will provide specific instructions on how to prepare for the biopsy. This may include temporarily stopping blood-thinning medications, emptying your bowel and bladder before the procedure, and fasting.
b) Anesthesia: Before the biopsy, a local anesthetic is usually administered to numb the area around the prostate gland. This helps minimize discomfort during the procedure.
c) Needle Placement: Using ultrasound or MRI guidance, the doctor inserts a biopsy needle through the rectum or perineum and into the prostate gland. Multiple samples are taken from different areas of the gland to increase the chances of detecting cancerous cells if present.
d) Tissue Sampling: Once the needle is in position, small tissue samples are collected by quickly removing and reinserting the needle. This process is usually repeated several times to obtain an adequate number of samples.
e) Post-Procedure Care: After the biopsy, you may be given antibiotics to reduce the risk of infection. It is normal to experience some blood in your urine, semen, or bowel movements for a few days after the biopsy. Contact your doctor if you have severe pain, heavy bleeding, or any other concerning symptoms.
Prostate biopsy is a vital tool in diagnosing prostate cancer and other prostate conditions. It helps identify the presence of cancer, determine its aggressiveness, and guide treatment decisions. By understanding the procedure, its benefits, and the expected results, individuals can make informed decisions about their prostate health. If you have concerns about prostate cancer, consult with your healthcare provider to determine if a prostate biopsy is appropriate for you.