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Ultrasound-Guided Biopsy of the Prostate

Kidney model

What is ultrasound-guided biopsy of the prostate?

An ultrasound-guided prostate biopsy is a procedure where a special probe the size of a finger is inserted into the rectum to take a small sample of tissue from the prostate gland. The sample then goes to a laboratory for testing.

Why is the procedure performed?

A prostate biopsy is currently the only way to diagnose prostate cancer. It also helps tell cancer apart from benign prostatic hyperplasia (BPH) or nodular enlargement of the prostate, a very common condition in middle-aged and older men that requires a different treatment approach than cancer.

Your doctor may order prostate biopsy if there is a nodule or other abnormality on the prostate detected during a digital rectal examination (DRE), a common prostate cancer screening test.

  • A biopsy also may be ordered when a blood test reveals elevated levels of prostate-specific antigen (PSA). Higher PSA levels are sometimes associated with cancer
  • A biopsy not only detects cancer; it also provides information on the aggressiveness of the cancer and helps to guide treatment decisions

How long does the procedure take?

The entire ultrasound-guided biopsy procedure usually takes 45 minutes or less.

How is the procedure performed?

The ultrasound-guided prostate biopsy is carried out by a radiologist or urologist, assisted by a sonographer and often a nurse who helps look after the patient.

  1. The procedure is often carried out after you have been given a light general anesthetic, which means you will be asleep or sedated during the procedure. If the procedure is carried out using an anesthetic, an anesthesiologist will be present. You also may receive medication for pain and anxiety.
  2. During the procedure, you will lie on your left side with your legs bent.
  3. The physician will first carry out a DRE with a gloved finger.
  4. An ultrasound probe will then be inserted into your rectum and the biopsy is performed with a spring-driven needle core biopsy device, or biopsy gun
  5. This biopsy sampling is repeated to ensure coverage of the visible abnormal area, and often samples are also taken in more normal-appearing areas to ensure the there is no other cancer. Usually, between six and 14 individual samples will be taken during the ultrasound-guided procedure and sent to a laboratory for analysis by the pathologist.

MRI Fusion Prostate Biopsy

A new, more accurate way of performing prostate cancer biopsies, MRI Fusion helps urologic surgeons remove the right amount of tissue to diagnose prostate cancer, reducing the risk of having to undergo a second biopsy.

This technique fuses pre-biopsy magnetic resonance images of the prostate with ultrasound-guided biopsy images in real time. This give urologist a clearer view of both normal tissue and of suspicious lesions.

 

After the biopsy samples are taken, the probe is removed and, if you have had a general anesthetic, you are awakened. You are then given a small pad to wear in case of any bleeding. You will be kept under observation.

What will I experience during and after the biopsy?

  • When the ultrasound probe is inserted into the rectum, you will feel pressure and may have some temporary discomfort
  • You will hear a clicking noise when the biopsy needle samples the prostate, and you may feel a stinging or burning sensation in the area
  • Some patients have a small amount of bleeding from the rectum or perineum right after the biopsy procedure. If this happens, it will stop with light pressure
  • If you haven’t been sedated, no recovery period is necessary. If you have had a light general anesthetic or sedation, you may feel groggy for a day or so
  • You may feel pain and discomfort in the area of the prostate for a day or two after the biopsy, particularly when you are seated