Our Summary

This study presents a new method for performing prostate biopsies on patients who have had their rectum removed, which typically makes this procedure more difficult. Due to better MRI imaging and increased testing for prostate-specific antigen (PSA), these patients are being diagnosed earlier. The new technique involves placing the patient under general anesthesia and using a catheter and contrast dye to visualize the prostate. This method was successfully used on two patients, one with a history of ulcerative colitis and the other with a history of Crohn’s disease, both of whom had their rectums removed. The researchers conclude that this is a safe and effective way to biopsy the prostate in such patients.

FAQs

  1. What is the new method for performing prostate biopsies on patients who have had their rectum removed?
  2. How does the new technique for prostate biopsy work?
  3. Is the new method for performing prostate biopsies proven to be safe and effective?

Doctor’s Tip

A doctor might tell a patient about prostate biopsy that it is a common procedure used to check for prostate cancer or other prostate problems. They may advise the patient to expect some discomfort during the procedure, but it is usually well-tolerated. The doctor may also recommend discussing any concerns or questions with them before the biopsy to ensure the patient is fully informed and comfortable with the procedure. Additionally, the doctor may remind the patient to follow any instructions given before and after the biopsy to ensure accurate results and a smooth recovery process.

Suitable For

Patients who are typically recommended for a prostate biopsy include:

  1. Men with elevated levels of prostate-specific antigen (PSA) in their blood, which may indicate the presence of prostate cancer.
  2. Men with abnormal results on a digital rectal exam (DRE), which may suggest the presence of a prostate abnormality.
  3. Men with a family history of prostate cancer, as they may be at increased risk for developing the disease.
  4. Men with symptoms of prostate cancer, such as frequent urination, blood in the urine, or difficulty urinating.
  5. Men with a previous history of prostate cancer, who may require regular biopsies to monitor for recurrence.
  6. Men with certain risk factors for prostate cancer, such as African American men or men over the age of 50.

Timeline

Before the prostate biopsy:

  • The patient may experience symptoms such as urinary problems, blood in the urine, or elevated PSA levels prompting further investigation.
  • The patient undergoes a digital rectal exam and possibly a transrectal ultrasound to assess the prostate.
  • The patient may be advised to stop taking certain medications, such as blood thinners, before the procedure.
  • The patient may be given antibiotics to prevent infection.

During the prostate biopsy:

  • The patient is placed under general anesthesia.
  • A catheter is inserted into the urethra to access the prostate.
  • Contrast dye is injected to visualize the prostate on imaging.
  • The biopsy needles are guided to specific areas of the prostate to collect tissue samples.
  • The procedure typically takes around 20-30 minutes.

After the prostate biopsy:

  • The patient may experience some discomfort or pain in the prostate or rectal area.
  • The patient may notice blood in the urine or semen for a few days after the procedure.
  • The patient may be advised to avoid strenuous activities and heavy lifting for a few days.
  • The biopsy samples are sent to a pathology lab for analysis, and the results are typically available within a week.
  • Depending on the results, further treatment or monitoring may be recommended.

What to Ask Your Doctor

  1. What are the risks and potential complications of a prostate biopsy, particularly for patients who have had their rectum removed?
  2. How do you determine if a prostate biopsy is necessary for a patient, especially if they have a history of inflammatory bowel disease?
  3. What is the success rate of this new biopsy technique for patients who have had their rectum removed?
  4. How does the use of general anesthesia impact the overall experience and recovery process for the patient during a prostate biopsy?
  5. Are there any specific preparations or precautions that need to be taken before undergoing a prostate biopsy with a history of inflammatory bowel disease?
  6. How soon can the results of the biopsy be expected and how will they be communicated to the patient?
  7. What follow-up care or monitoring should be expected after a prostate biopsy, especially for patients with a history of rectal surgery?
  8. Are there any lifestyle changes or recommendations that should be considered after a prostate biopsy, particularly for patients with inflammatory bowel disease?
  9. How does having a history of ulcerative colitis or Crohn’s disease impact the overall prognosis or treatment plan following a prostate biopsy?
  10. Are there any alternative methods or technologies that can be used for prostate biopsy in patients who have had their rectum removed?

Reference

Authors: McNicholas DP, Parr NJ. Journal: BJU Int. 2024 Apr;133(4):487-490. doi: 10.1111/bju.16279. Epub 2024 Jan 18. PMID: 38234225