Transperineal (template) biopsy

Learn more about transperineal biopsies at King Edward VII’s Hospital

Why would I need a transperineal (template) biopsy?

Your urologist will suggest a biopsy of your prostate if they think that you may have prostate cancer. This might be because of a suspicious area on your prostate MRI scan. Other reasons to be concerned that you have prostate cancer are a high blood test, known as prostate specific antigen or PSA, or a prostate that feels abnormal on examination.

Having a biopsy does not necessarily mean that you have prostate cancer. Other reasons to have a high prostate blood test, or a suspicious area on MRI are an infection or inflammation in the prostate.

What symptoms does a transperineal (template) biopsy address?

This kind of procedure isn’t used to treat any symptoms. Instead, it’s a test used to look for the presence or absence of cancer in the prostate.

When should you speak to your GP about a transperineal (template) biopsy?

If your GP suspects there is a possibility you may have prostate cancer, they will discuss your options with you, including having a prostate biopsy to test for prostate cancer.

Speak to your GP if you have any of the following symptoms which can be an indication of prostate cancer:

• The need to pass urine more often, especially during the night
• An urgent need to pass urine
• Difficulty in starting to pass urine
• A weak flow or trickling when you pass urine
• A feeling that you haven’t emptied your bladder even though you’ve just been to the toilet
• Blood in your urine or semen

However, most men with localised prostate cancer don’t have any symptoms, and have a high prostate blood test called prostate specific antigen (PSA).

How is a transperineal (template) biopsy performed?

A transperineal (template) biopsy is usually carried out under a general anaesthetic and most men can return home the same day. You will normally be required to have an MRI scan prior to your biopsy procedure, to help guide the biopsy.

Your surgeon will insert an ultrasound probe into your rectum. This allows them to clearly see your prostate on a nearby screen.

Then, using a special grid and information from your MRI scan, they will take various samples of tissue from your prostate using a very fine needle, inserted through your perineum (the area of skin between your rectum and testicles).

The procedure takes around half an hour.

What is the recovery like for a transperineal (template) biopsy?

Your recovery from a transperineal (template) biopsy will depend on multiple factors, including your age, fitness level and the nature of your procedure.

For the first two weeks following your procedure, you may notice blood in your urine or semen. This is normal, and will usually clear up after two weeks.

You may also have some discomfort which may last a few days and can be managed with painkillers.

Your medical team will advise of your next steps after reviewing the results of your biopsy.

Are there any risks/complications associated with a transperineal (template) biopsy?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your GP or surgeon beforehand will help you understand any potential side effects.

A transperineal (template) biopsy has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

• Infection
• Difficulty urinating

How can I prepare for a transperineal (template) biopsy?

Prior to a transperineal (template) biopsy, your surgeon will discuss with you how best to prepare for surgery, as each patient is different.

Are there alternatives for a transperineal (template) biopsy?

A transrectal ultrasound guided biopsy can also be used to take tissue samples from the prostate. This kind of biopsy is often carried out under a local anaesthetic and samples are taken from the prostate through the wall of the rectum.

This is an older procedure and can sometimes be unnecessarily risky for some men, as there is the risk of serious infection that can need hospital treatment. It can also be more difficult to target suspicious areas on MRI using a transrectal approach. Your urologist can discuss both methods with you.