Prostate Biopsy (TRUS Biopsy)
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In order to be sure of the cause of an elevated PSA or abnormal prostate examination (DRE), it may be necessary to do a biopsy of the prostate. This involves passing a small needle into the prostate under ultrasound guidance and obtaining tissue which can be sent to the laboratory for histological diagnosis. This is currently the most accurate test for the diagnosis or exclusion of prostate cancer. | |
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Ultrasound picture of the prostate |
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The test is carried out in the ultrasound department and involves a probe a little larger than a finger being inserted into the back passage (this is similar to the examination you had in the clinic). After measuring the size of the prostate and noting any abnormal features on the ultrasound a small spring loaded needle is inserted through the probe and between six and ten biopsies are taken. The biopsies may cause some discomfort but are not usually painful.
After the test you will be invited to rest in the department for half an hour or so then you may go home. The results will be available after two to four days depending on whether any special laboratory tests are required.
Do I need any preparation for the tests?
There is no physical preparation required unless you have a history of abnormal bleeding or are taking blood thinning medication. Where possible we recommend stopping regular aspirin for ten days prior to the test as this may be associated with a slight increase in bleeding following the procedure.
You will be given antibiotics to take at the time of the test to reduce the risk of urinary infection.
What should I expect afterwards?
There may be some blood in the urine, semen or stools for a week or so after the biopsy. If this is still troublesome when you are seen with the results of the biopsy a urine sample can be checked to rule out infection.
You may experience some discomfort in the pelvis or testicles: this should respond to simple painkillers such as paracetamol.
Rarely an infection may occur: if you notice a high fever, have shivering attacks or feel unwell you should contact us immediately, or contact your family doctor letting him know you have had a prostate biopsy.
Are there any restrictions after the test?
None, apart from avoiding alcohol and sunbathing as mentioned above.
If you have sex you may have some discomfort on ejaculation. This is nothing to worry about and there is no risk of passing on any infection or cancer after the test.
Who looks at the biopsies?
The biopsies are sent either to King's College Hospital or to Bostwick Laboratories. Here they are looked at by consultant pathologists who sub-specialise in urology cancer diagnosis..
Is the test 100% effective?
Although this is the best method of assessing a prostate cancer, it is possible to miss a small tumour as only a percentage of the prostate is examined. Rarely it may be necessary to redo a biopsy but this will usually be only after discussion with the urologist and a check on the PSA after excluding any infection in the prostate. Normally a negative biopsy means benign disease. For some men we may recommend the use of further molecular tests (eg the UPM-3 test) if the PSA remains high. If a previous biopsy is negative or shows very small spots of disease we may recommend a template biopsy, in which a larger number of biopsies are taken from all zones of the prostate under a very light anaesthetic.
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