Prostate Ultrasound and Biopsy
Prostate ultrasound and biopsy is a diagnostic procedure to determine if a man has prostate cancer. It is usually performed in the urologist's office, but can be performed in an outpatient surgery center if more sedation is required. The entire procedure usually lasts less than 10 minutes.
Prostate ultrasound uses an ultrasound
transrectal prostate ultrasound and biopsy
probe which is inserted into the rectum the same way a finger is used to examine the prostate. The ultrsound probe uses sound waves to take a detailed picture of the size and shape of the prostate. Men lay on their left side during the procedure with the knees curled up toward the ches. There may be a small amount of discomfort when the probe is inserted, but usually not much more than with a finger exam. A numbing jelly is placed into the rectum prior to the procedure to decrease any pain. Ultrasound pictures of the prostate are taken to determine the size and shape of the prostate and to look for any areas that are suspicious for prostate cancer. The ultrasound is then use to guide the prostate biopsies to the correct place in the prostate
Prostate biopsy is performed with a small needle which is placed in a spring-loaded "gun" which shoots the needle through the ultrasound probe into the prostate. The needle cuts out a small thread of prostate tissue which can be examined for prostate cancer. Most men feel a sharp pinch in the rectum when the biopsies are taken, but the sharp sensation lasts for only a fraction of a second. Usually 5-6 biopsies are taken from each side of the prostate. When the biopsies are finished many men will have a feeling that they need to urinate, but the feeling will usually subside before men are dressed and ready to go home.
You do not need to stop aspirin before prostate biopsy, but you usually need to stop Coumadin for 4-5 days before a biopsy. You should discuss this with the doctor. You will be given an enema to take several hours before the biopsy to clean your lower colon. You will also be given antibiotic tablets to take before the biopsy and for 2 day after the biopsy. If you are having the biopsy in the office and would like mild sedation, then someone must be able to drive you home after the procedure. Tell the receptionist that you would like oral sedation and you will be given valium and/or vicodin tablets to take.
All men have a small amount of bleeding from the rectum that they will see on the toilet paper for several days after the biopsy. Some men will also see a small amount of blood at the beginning of urination, and this will stop within one week. All men will have blood in the semen for 4-6 ejaculations after prostate biopsy. Climax and ejaculation should not feel any different than before the biopsy and no special precautions are necessary unless patients have a condition which could be spread by blood contact, such as hepatitis or AIDS.
The more serious risks after prostate biopsy are rare. Approximately 1% of men will have severe difficulty urinating or be unable to urinate after prostate biopsy. This is caused by temporary swelling in the prostate. Roughly 1 out of 1000 men will have a prostate infection or significant bleeding after prostate biopsy.