prostate biopsy

What is involved in the prostate biopsyprocedure?

In the majority of cases, the prostate biopsy is done via the transperineal route

This procedure can be done under local anaesthesia in office or under general anaesthesia in the operating room


prostate biopsy main points

Key Points:

Transperineal ultrasound-guided biopsy checks for prostate cancer.

  • No more reliable method for prostate examination than biopsies.

  • Common side effects include bleeding and reduced urinary flow. Infection is a rare occurrence.

  • Diagnosed prostate cancers may not be life-threatening. Some cases require no active treatment, only careful monitoring.

  • In selected cases, in-bore MRI-guided prostate biopsy is utilized.

  • This advanced technique enhances precision and diagnostic reliability in scenarios involving a large prostate and a small target.

surgery

What occurs on the day of the procedure?

A/Prof Homi Zargar will discuss the surgery once again to ensure your understanding and obtain your consent. An anaesthetist will meet with you to explore the options of a general or spinal anaesthetic and discuss post-procedure pain relief.

Details of the procedure:

  • Procedure is often performed under local anaesthesia, sometimes general or spinal needed.

  • Positioning in specialized supports for scrotum skin access.

  • Use of tape to reposition scrotum; prostate examined first.

  • Perineum cleaned with an antiseptic solution; local anaesthetic stinging may occur briefly.

  • Probe, about the width of a thumb, used for prostate biopsies.

  • Biopsy needles guided using an ultrasound scanner; additional guidance via MRI images.

  • The number of biopsies depends on PSA level, MRI report, and risk factors.

  • Procedure duration: 30 to 45 minutes; home within hours or 24 hours post-procedure.

  • A/Prof Homi Zargar is the pioneer of this technique in Victoria.

  • A/Prof Homi Zargar has conducted the most number of biopsies under local anaesthesia in the office setting.

Post-Biopsy Effects:

  • Blood in urine for up to 10 days - Almost all patients.

  • Blood in semen, lasting up to six weeks - Almost all patients.

  • Bruising and Discomfort:

    • Bruising in perineal area - Between 1 in 2 and 1 in 10 patients.

    • Discomfort in the prostate due to biopsy-related bruising - Between 1 in 2 and 1 in 10 patients.

    • Temporary erection problems from biopsy-related bruising - 1 in 20 patients (5%).

  • Urinary Issues:

    • Inability to pass urine (acute retention) - 1 in 20 patients (5%).

    • Bleeding in urine causing clot retention - 1 in 50 patients (2%).

  • Cancer Detection and Repeat Procedures:

    • Failure to detect significant prostate cancer - Between 1 in 10 and 1 in 50 patients.

    • Need for a repeat procedure for inconclusive biopsies or rising PSA - Between 1 in 10 and 1 in 50 patients.

  • Emergency Situations:

    • Bleeding in urine requiring emergency admission - 1 in 100 patients (1%).

    • Urine infection requiring antibiotics - 1 in 100 patients (1%).

    • Septicaemia (blood infection) requiring emergency admission - Less than 1 in 100 patients.