TRUS-PROSTATIC BIOPSY

What is transrectal ultrasound?

Your urologist has advised this test to check your prostate. This involves inserting a well-lubricated small ultrasound probe through your back passage (anus) into your rectum. Although there will be some discomfort this is only minor and the procedure should take no more than a few minutes.

What is prostate biopsy?

Your urologist has advised biopsies (samples) of your prostate either because your PSA was elevated or your prostate feels abnormal. After the ultrasound probe is introduced and measurements of the prostate have been done, the doctor or nurse doing the procedure may inject some local anaesthetic around the prostate. Following this several needle cores of prostate tissue are obtained. This may cause some minor discomfort and the entire procedure should take no more than a few minutes.

What can I expect after the biopsy?

Depending on the local policies in your hospital, you are likely to be given antibiotic tablets before the planned biopsies of the prostate. If so, this will be continued for another 48-72 hours.

After the biopsies are done you may be asked to lie flat for a few minutes. You would have been warned about the following side effects / anticipated complications:

  Bleeding from your back passage. This typically lasts only for 1-2 days.
  Blood mixed with your urine. This again is only transient. This will settle by drinking plenty of fluids.
  Blood mixed with your ejaculate. This may last up to a couple of months.
  Urinary infection / sepsis – this is prevented by the antibiotic tablets, but in up to 3-5% of cases, fever that may be associated with chills signifies the presence of sepsis. If this happens to be the case, you need to report to your hospital straight away so that you can be given intravenous antibiotics to control the infection.

If you are a working person, it is better to take the day off and take it easy.

Is there any special preparation for this procedure?

No, but if you are taking blood thinners like warfarin / coumadin, aspirin or clopidogrel, you will need to stop these for 5-7 days prior to the biopsy in order to avoid excessive bleeding. Of course, your urologist will advise you after having discussed this with your cardiologist.

Do I need to be admitted to hospital for this procedure?

No, this is usually done as an outpatient procedure. Of course, it is prudent to bring somebody along with you to take you back home.

When will I know about the results of the biopsy?

The tissue cores of prostate are sent to a pathologist who has to make slides from these and study them in significant detail to see if you have cancer in the prostate. This usually takes a couple of days. Your urologist will then discuss the results with you and agree on a management plan with you.