Prostate Biopsy
Prostate Biopsy
A prostate biopsy, also known as a needle biopsy, is a minor procedure in which a needle is used to obtain tissue samples from the prostate for diagnostic examination. The prostate is a gland located in the male urinary tract that functions for reproduction. As you get older, the prostate gradually increases in size.
The enlargement of the prostate may cause no symptoms or it may interfere with urination. Symptoms such as increased frequency of urination, decreased force of urinary stream, difficulty urinating, or awakening at night to urinate may be signs of benign prostatic enlargement or a prostatic nodule.
Benign enlargement is a normal increase in the size of the prostate and does not require a biopsy. A nodule is a firm or hard area within the prostate. Dr. Huffer will perform an examination to determine if a biopsy is recommended. He may also recommend a prostate biopsy if the prostate-specific antigen (PSA) levels in your blood are too high.
The enlargement of the prostate may cause no symptoms or it may interfere with urination. Symptoms such as increased frequency of urination, decreased force of urinary stream, difficulty urinating, or awakening at night to urinate may be signs of benign prostatic enlargement or a prostatic nodule.
Benign enlargement is a normal increase in the size of the prostate and does not require a biopsy. A nodule is a firm or hard area within the prostate. Dr. Huffer will perform an examination to determine if a biopsy is recommended. He may also recommend a prostate biopsy if the prostate-specific antigen (PSA) levels in your blood are too high.
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How To Prepare
A prostate needle biopsy is a minor procedure which takes only 15-20 minutes to perform and is generally done in our office. However, some preparation is needed to ensure the biopsy goes smoothly and safely:
- To ensure that bleeding risks are minimized, tell Dr. Huffer or his staff if you take blood thinning medication such as aspirin, Plavix (clopidogrel), Brilinta (ticagrelor), Coumadin (warfarin), Eliquis (apixaban) or Lovenox (heparin). Do not take any aspirin for 7 days prior to the procedure. Other blood thinning medications should be withheld for the prescribed amount of time, and with the supervision of the prescribing doctor.
- Antibiotics must start the day before the biopsy, with an additional pill taken the morning of the biopsy. The best antibiotic levels are obtained if the second pill is taken approximately 2 hours before the biopsy.
- A Fleets enema should be administered about two hours before the visit. You can buy the enema at any drug store and follow the instructions on the package.
- Non-steroidal anti-inflammatory medication such as ibuprofen or Naprosyn and Vitamin E should be stopped 3 days before the biopsy.
Prior to the procedure, you will be asked to sign a consent form that declares that you understand the procedure and risks involved.
What To Expect
On the day of your procedure, the experienced and professional team at Southeast Alaska Urology will ask you to urinate to provide a specimen. If there is any sign of infection, the procedure might need to be rescheduled. There will be no dietary restrictions on the day of the procedure. Here is what to expect on the day of your biopsy procedure:
Arrival
After arriving at the office, we will ensure that you have successfully completed the pre-biopsy instructions and have signed the consent form. If any problems are identified, we might need to reschedule the procedure.
Bathroom
We will ask you collect a small urine sample when you use the restroom in order to rule out a urinary tract infection.
Changing Room
You will be escorted into a procedure room and given a disposable sheet to cover yourself after you undress from the waist down, leaving on your socks.
Biopsy Room
To perform the biopsy, you will be asked to lie down on your side on the exam table. When the ultrasound begins we will have you bend both knees towards your chest and hold them there until the exam is complete.
Ultrasound Probe
The ultrasound probe is lubricated and gently inserted through the anus into the rectum until it rests just behind your prostate. Using ultrasound waves we will see the inside of your prostate on a monitor. A generous amount of numbing medication will be strategically delivered via a needle to numb the prostate. We will scan the entire prostate and take measurements of the prostate size. After around 4-5 minutes, the measurements are completed and we are ready to begin the prostate biopsy.
Digital Rectal Examination
In most cases, we will begin by performing a digital (finger) rectal exam of the prostate to reexamine the prostate gland for nodules or irregularities.
Biopsy
After aiming the ultrasound probe at a certain area of the prostate, the biopsy needle will be inserted through the ultrasound probe needle guide to reach your prostate. You may feel a pinch or some pressure as the needle is inserted into the prostate. An automated spring-loaded needle quickly removes a small prostate tissue sample. This is usually repeated 12 times.
After the Biopsy
For 24 hours after the procedure, it is common to experience mild rectal discomfort. You may experience a small amount of bleeding in the urine, rectum, or in the ejaculate for 1 to 2 weeks following the procedure. Brownish ejaculate may occur for 1 to 2 months.
To facilitate a speedy recovery, please adhere to the following instructions post-procedure:
- Take antibiotic after the procedure as directed by your physician.
- No heavy lifting for 24 hours.
- If you have not done so beforehand, you must consult with Dr. Huffer, as well as your primary care physician, cardiologist, or MIU physician for instructions on resuming your blood thinning medication.
- Do not resume aspirin or non-steroidal anti-inflammatory medications for up to 3 days following the procedure.
- Drink extra fluids for the next 24 hours.
Possible Complications
Contact Southeast Alaska Urology if you experience any of the
following complications:
- Temperature above 100.5°F
- Continuous bright red blood from either the rectum or urine
- Do not resume aspirin or non-steroidal anti-inflammatory medications for up to 3 days following the procedure.
- Difficulty urinating with or without blood clots
- Severe pain in the rectal area
