How is a Prostate Biopsy Performed?
Transrectal biopsy of the prostate is performed as an outpatient in an office setting. After the patient has undergone a blood test to ensure that there is no abnormality with the patient’s ability to form a blood clot, and after the patient has received prophylactic antibiotics, the test is performed. A small ultrasound probe is placed in the rectum and ultrasound images are obtained. At the time of the ultrasound, it is possible that suspicious regions of the prostate will be identified. If this occurs, these particular areas of interest can be biopsied. So-called “targeted biopsies” tend to result in a higher likelihood of detecting cancer in the prostate. If no suspicious lesions are identified, most urologists obtain 6-12 biopsies from specific locations distributed over both sides of the prostate. Some centers are performing supersaturation biopsies (a minimum of 24 specimens are obtained) and these biopsies are usually done in the operating room under anesthesia.
If done in the outpatient setting, most urologists inject a local anesthetic into the group of nerve bundles that are adjacent to the prostate. This will help to alleviate the discomfort that would otherwise be associated with the biopsy. A small needle is then directed into the prostate at various locations and the needle extracts small cores of the prostate. These cores are then processed and analyzed by a pathologist and the determination made if prostate cancer is present.
What to Expect After a Prostate Biopsy
After the procedure is performed, most patients will experience minimal discomfort. Patients usually experience blood in their semen for several weeks (hematospermia) and have a small amount of blood on their stool or from their rectum for several days. Patients will usually be given an oral antibiotic after the procedure. Elevated fevers (over 101 degrees) or heavy bleeding should be of concern and the patient should contact their urologist if this occurs.
Jay Motola, MD, is a board-certified urologist and attending physician, Department of Urology, Mount Sinai West, and Assistant Professor of Urology, Icahn School of Medicine at Mount Sinai. Dr. Motola is a summa cum laude, Phi Beta Kappa graduate of Boston University, and earned his medical degree at the State University of New York at Stony Brook.