Infection: The most serious risk of a prostate biopsy is the risk of infection, including urinary tract infections and, less commonly, sepsis. However, recent studies found that with appropriate interventions, such as administering a double course of antibiotics and taking other precautions, infection-related hospitalizations after prostate biopsy fell from 1.
Discomfort: Patients may also fear the procedure will cause discomfort. Your urologist will most likely use a local anesthetic to alleviate pain. The decision of whether to undergo a prostate biopsy should be determined after an individual conversation with your doctor during which he or she presents you with the big picture of your situation. Compare, for example, the case of two year-old men: One of them has been diagnosed with heart failure and is in poor overall health.
The other has no pre-existing health conditions. In his case, it would be better to risk the prostate biopsy to catch the cancer early and improve his chances of long-term survival.
There are few other diagnostic tools or tests, which can be performed before you have a prostate biopsy, that may help your physician gather more information about your specific case. These procedures may help determine the likelihood of the presence of cancer and its aggressiveness and increase the accuracy of a biopsy when performed. Those tests include:. If you're a patient whose PSA values are borderline for a prostate biopsy or you have a condition that could be aggravated by a biopsy, your physician may use this test before to help determine whether you should get a biopsy or a repeat biopsy.
Urine sample test looks for biomarkers that may indicate the presence of prostate cancer cells in a patient's body. This test may also be helpful when trying to determine whether a patient should be rebiopsied or not. The use of multiparametric MRI mpMRI imaging of the prostate gland before a biopsy has been a game changer in prostate cancer diagnosis, increasing the accuracy of biopsies over standard biopsies.
The mpMRI doesn't replace the standard biopsy, but by improving its accuracy, it may help decrease the number of biopsies needed. The mpMRI has a higher resolution than a standard prostate ultrasound. This increases the ability to see suspicious lesions in the prostate, providing additional targets for the biopsy to sample.
It has a false negative rate of about 40 percent because some cancer cells are too small to be detectable. So, even if your MRI is negative meaning no lesions were found , we still recommend you undergo a prostate biopsy when your urologist recommends it. Biopsy samples of the tissue are necessary for that determination.
If the mpMRI shows an abnormality in your prostate, we can then sync the images obtained during the MRI with the images from the transrectal ultrasound TRUS of your prostate during the biopsy. This is called an MRI-fusion biopsy , and it provides us with a visual target of the sampling area in real time. I've been recommending and performing MRI-fusion biopsies for the past seven years.
Two years ago, the NCCN added it to its standard-of-care guidelines for initial prostate biopsy. Our team has expertise with these tests and procedures, allowing us to work quickly and efficiently. We give you the pros and cons of the treatment options available to you, allowing you time to talk with your team of doctors and other experts about those options. Our cancer experts are also vigilant about what patients need and when they need it. If you choose to receive treatment with us, you may benefit from our integrative approach to cancer treatment.
Our multidisciplinary team works together to help prevent and manage the side effects of cancer and its treatment, providing supportive care services , such as:. Before you make a decision about whether to have a prostate biopsy, we recommend you have a conversation with your physician and ask:. You may also want to consider getting a second opinion and, if possible, consult with a urologic oncologist.
It's important to remember that the statistics surrounding prostate cancer, its diagnosis and treatment are gathered at the population level. Transrectal method. This is done through the rectum and is the most common. Perineal method. This is done through the skin between the scrotum and the rectum. Transurethral method. This is done through the urethra using a cystoscope a flexible tube and viewing device.
A prostate biopsy is done after other tests show that there may be a problem with the prostate gland. It is the best method to diagnose prostate cancer. You may have other risks, depending on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure. You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if anything is not clear. Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, and anesthesia.
Make sure your healthcare provider has a list of all medicines prescription and over-the-counter and all herbs, vitamins, and supplements that you are taking. Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant blood-thinning medicines, aspirin, or other medicines that affect blood clotting. You may need to stop these medicines before the procedure. Generally, no prior preparation, such as fasting or sedation, is needed for the transrectal or perineal method.
If the transurethral method is to be used, general anesthesia may be used. If you are to have general anesthesia, you may be told to fast not eat or drink anything before the procedure, generally after midnight.
Your healthcare provider will give you specific instructions. If your healthcare provider uses the transrectal method, you may need to use an enema the night before or the morning of the biopsy.
You may get a sedative before the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home. You will most likely get a sedative if your healthcare provider is using the transurethral method. You may start to take antibiotics the day before the biopsy is done and continue them for a few days after it. This is to help prevent infection. A prostate biopsy is usually done on an outpatient basis.
Procedures may vary depending on your condition and your healthcare provider's practices. This type of biopsy may be done with a local anesthetic to numb the tissue the needle will pass through.
Usually, a transrectal ultrasound TRUS will be used to guide the placement of the biopsy needle. The healthcare provider will use a spring-loaded tool that quickly inserts a needle through the wall of the rectum into the prostate gland. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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