How to get the best results from a prostate biopsy

How to get the best results from a prostate biopsy

Hearing the words, “You need a prostate biopsy,” can be unsettling and scary.  But it doesn’t need to be especially when you are informed about what a prostate biopsy is and how it is performed.  A biopsy is any type of procedure that involves taking a piece of tissue from the body to be examined under a microscope.  A doctor will determine if the tissue contains cancer or abnormal cells.  Depending of the results of the biopsy can help determine the next best step in diagnosis or treatment.  

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When it comes to a biopsy of the prostate, your urologist may recommend a biopsy if the result from a prostate specific antigen (PSA) blood test comes back abnormal or has risen to a level that might indicate prostate cancer or a digital rectal exam (DRE) feels suspicious.  Before performing a biopsy, your urologist will take into account your age, general health, family history, ethnic background as well as the results of other testing.  Performing a prostate biopsy will determine whether prostate cancer is present or not, and if so, which treatment option is best and appropriate for the type and stage of cancer diagnosed. 

Many men naturally have concerns over the procedure, especially in such as sensitive and intimate part of their body.  The best way to overcome any fear or concerns is to be informed and to always discuss them with your doctor.

Will the prostate biopsy be painful?

This is likely a common concern of many men next to the fear of receiving their biopsy results. Pain is very subjective. Everyone has their own personal pain tolerances – some men take it in stride while others are more perceptive of possible pain. What you should know is your urologist will have in place plans to reduce your pain as much as possible. They want you to be comfortable with little if any pain.  Ask what method they plan to do and insist on pain medication to help you through the procedure.

How to get the best results

Certain steps can be taken before, during and after the procedure to improve the outcome:

·      Take antibiotics – Taking preventive antibiotics – before and after the procedure – reduces the risk of infection substantially. Most infections are not dangerous but could become so if they get out of control. The overall chance of being hospitalized with an infection after prostate biopsy is 1% to 3%.

·      Review medication – Before the biopsy, your doctor may advise you to stop taking daily low-dose aspirin or an anticoagulant (blood thinner) such as warfarin (Coumadin), dabigatran (Pradaxa), edoxaban (Savaysa), rivaroxaban (Xarelto), or apixaban (Eliquis). These drugs reduce the blood’s ability to clot. Your doctor will weigh the chance of bleeding against the need for anticoagulants to prevent heart problems or stroke.

·      Expect anesthesia – Get local anesthesia for the biopsy. This means an injection of a numbing drug into the prostate gland to reduce pain during the biopsy.

What happens during a prostate biopsy?

What exactly does a prostate biopsy entail?  The procedure itself usually only takes a quick 10 to 15 minutes and is often done in the urologist’s office.  Based upon your risk assessment determined by your urologist, your procedure may vary in the core number of tissue specimens obtained and may include MRI imaging. 

Before the biopsy begins, an antibiotic will be given to reduce the possibility of infection.  During the biopsy, medicine is used to numb the nerves that supply the prostate so you should only feel some pressure but no sharp pain while the procedure is taking place.  This is accomplished by the urologist placing a probe in the rectum and will then numb the area with an injection of a local anesthetic.  Then, the doctor will insert a thin, hollow needle through the wall of your rectum, into the prostate.  When the needle is pulled out, it removes a small amount of prostate tissue.  Multiple tissue samples from different areas of the prostate will be taken.

The samples are sent to a lab where they will be examined under a microscope for abnormal cells with the results coming back in a few days.  If the results are positive for cancer, the biopsy will help your doctor counsel you on your best treatment options.

What to watch for afterward

After the procedure, you will be asked to take it easy for a day or two.  Men will likely experience symptoms that are considered normal after a prostate biopsy which include the following:

·      Pain in the area between the anus and scrotum for a few days to a week.

·      Blood in your urine for a few days to several weeks.

·      Blood in the stool for a day or so. If it lasts longer, notify your physician.

·      Blood in the semen for three to six weeks, and possibly longer.

If any of the above symptoms persist or become worse, contact your urologist as soon as possible.

Be sure to notify your physician if rectal or urinary bleeding gets worse. Be on guard for the first 24 to 48 hours for signs of a serious infection in the urinary tract or prostate gland.  Signs to be aware of are fever or chills.  If you experience this, go to a hospital immediately as it likely is a sign of an infection and needs treated right away.

Prostate biopsies are considered very safe procedures and are valuable for helping you and your doctor decide on what treatments may need to occur.  Always discuss with your doctor any questions or concerns you may have about your prostate biopsy.