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Transrectal Ultrasound Guided Biopsy

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Why would I need a transrectal ultrasound guided biopsy?

You may need to have this kind of prostate biopsy if the results of a prostate specific antigen (PSA) blood test have shown high levels of PSA in your blood, indicating the potential for prostate cancer. Having this test does not necessarily mean that you have prostate cancer.

It can also be used if your specialist has felt a swelling or a lump in the region of the prostate after performing a digital rectal examination.

What symptoms does a transrectal ultrasound guided biopsy address?

A transrectal ultrasound guided biopsy doesn’t treat any symptoms. Instead it’s a type of test that’s performed to look for the presence or absence of cancerous cells in the prostate.

It can also be used to look for an enlarged prostate or inflammation of the prostate, called prostatitis.

When should you speak to your specialist about a transrectal ultrasound guided biopsy?

Speak to your specialist 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

If you’ve had a PSA blood test and/or a digital rectal examination and your specialist is concerned about your risk of prostate cancer, they will discuss your options with you. One option is to have a transrectal ultrasound guided biopsy.

How is a transrectal ultrasound guided biopsy performed?

A transrectal ultrasound guided biopsy is usually performed under a local anaesthetic. You will be awake but the area around your prostate will be numbed to reduce any pain or discomfort. Most men can go home on the same day as the procedure.

Whilst you’re lying on your side with your knees up to your chest, your doctor will pass a long, thin ultrasound probe into your back passage. The ultrasound probe allows your doctor to see your prostate on a nearby screen.

They will then use a very thin needle to remove some tissue samples from the prostate through the wall of your rectum, guided by the ultrasound probe. The procedure will take around ten minutes.

What is the recovery like for a transrectal ultrasound guided biopsy?

Your recovery from a transrectal ultrasound guided biopsy will depend on multiple factors, including your age, fitness level and the nature of your procedure.

After your procedure, you may feel some pain or discomfort in your rectum which should be relieved with painkillers. You may also notice blood in your urine, semen and/or stools which should disappear within two weeks.

Some men find it difficult to urinate after this procedure as it can cause the prostate to swell and block the normal passing of urine from the bladder. If this happens, you may need a catheter inserted for a few days.

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

Are there any risks/complications associated with a transrectal ultrasound guided biopsy?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

A transrectal ultrasound guided biopsy has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

  • Longer term bleeding
  • Infection
  • Difficulty urinating
  • Erectile dysfunction

How can I prepare for transrectal ultrasound guided biopsy surgery?

Prior to a transrectal ultrasound guided biopsy, your surgeon will discuss with you how best to prepare for surgery, as each patient is different.

Common preparations for a transrectal ultrasound guided biopsy include:

  • Routine blood tests, x rays or scans as requested by your surgeon
  • Taking steps to stop smoking if you smoke
  • Losing weight if you’re overweight
  • Remaining active and doing regular exercise

Are there alternatives for a transrectal ultrasound guided biopsy?

A transperineal biopsy can be used in place of a transrectal biopsy, which means that prostate biopsies are taken via a needle inserted through the perineum, the space between the rectum and the testicles, under a general anaesthetic. Your specialist can discuss both methods with you.

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