Our Summary

This research paper discusses the changing methods of performing prostate biopsies. Traditionally, doctors used a method called transrectal approach, where a biopsy is taken through the rectum. However, this method carries a high risk of serious infections, including a severe condition called sepsis. Recently, there’s been a shift towards using a method called transperineal prostate biopsy, which involves taking a biopsy through the skin between the anus and scrotum. This method carries a lower risk of infection. This paper discusses the benefits of this newer method and the technological advancements that have made it possible to perform this procedure in outpatient settings, meaning patients can go home the same day. The procedure can also be done under local anesthesia, which numbs a small area of the body and allows patients to stay awake.

FAQs

  1. What is the difference between a transrectal and transperineal prostate biopsy?
  2. Why has the transperineal prostate biopsy approach been increasingly adopted in recent years?
  3. Can a transperineal prostate biopsy be performed in an outpatient setting under local anesthesia?

Doctor’s Tip

A doctor may advise a patient undergoing a prostate biopsy to drink plenty of water before the procedure to help reduce the risk of infection. Staying hydrated can help flush out bacteria and reduce the likelihood of complications.

Suitable For

Patients who are typically recommended to undergo a prostate biopsy include those with elevated prostate-specific antigen (PSA) levels, abnormal digital rectal examination findings, or suspicious findings on imaging studies such as MRI. Additionally, patients with a family history of prostate cancer or other risk factors may also be recommended to undergo a prostate biopsy. It is important for patients to discuss the potential risks and benefits of the procedure with their healthcare provider to determine if a prostate biopsy is appropriate for their individual situation.

Timeline

  • Patient is referred for a prostate biopsy by their healthcare provider after abnormal results on a prostate-specific antigen (PSA) test or digital rectal exam
  • Patient receives instructions on how to prepare for the procedure, which may include stopping blood-thinning medications, taking antibiotics, and possibly using an enema
  • On the day of the biopsy, the patient arrives at the medical facility and is taken to the procedure room
  • Patient is positioned on their side or back, and a local anesthetic is administered to numb the area
  • Using either a transrectal or transperineal approach, the doctor inserts a thin needle into the prostate to collect tissue samples
  • After the biopsy, the patient may experience some discomfort, bleeding, or blood in the urine or semen
  • Patient is monitored for any signs of infection or other complications in the hours and days following the procedure
  • Results of the biopsy are typically available within a week, and the patient meets with their healthcare provider to discuss the findings and next steps
  • Depending on the results, the patient may require further testing or treatment for prostate cancer, or may be advised to continue regular monitoring through PSA tests and exams.

What to Ask Your Doctor

  1. What are the reasons for recommending a prostate biopsy?
  2. What are the potential risks and complications associated with a prostate biopsy?
  3. How will the biopsy be performed (transrectal vs. transperineal approach)?
  4. Will I need to be sedated or receive anesthesia during the procedure?
  5. How long will the biopsy procedure take?
  6. Will I experience any pain or discomfort during or after the biopsy?
  7. How soon will I receive the results of the biopsy?
  8. What happens if the biopsy results show abnormalities or signs of cancer?
  9. Are there any specific post-biopsy instructions I should follow for recovery?
  10. Are there any alternative options to a prostate biopsy that I should consider?

Reference

Authors: Bhanji Y, Allaway MJ, Gorin MA. Journal: Urol Clin North Am. 2021 Feb;48(1):25-33. doi: 10.1016/j.ucl.2020.09.010. PMID: 33218591