A prostate biopsy has long been the standard of care for diagnosingprostate cancer.
This reduces the risk of a needless biopsy and has proven far more accurate in diagnosing prostate cancer.
It also walks you through what the findings mean and what happens next if cancer is found.
Illustration by Emily Roberts, Verywell
When Is a Prostate Biopsy Needed?
The decision to pursue the biopsy is largely directed by theprostate-specific antigen (PSA) test.
This is a blood test that detects a protein released in greater quantities when theprostate glandis inflamed.
The test does not detect cancer, but very high PSA levels indicate that prostate cancer may be involved.
This translates to a 38% reduction in unnecessary biopsies.
When Is a High PSA a Sign of Cancer?
There is no hard-and-fast rule as to when a PSA is a sign of cancer.
How Painful Is a Prostate Biopsy?
You may feel pressure and even uncomfortable sensations, but no outright pain.
If you do, let the surgeon know.
This is why you are likely to be advised to avoid driving yourself home after the biopsy.
How Long Do Local Anesthetics Last?
These side effects tend to be relatively manageable and persist for no more than a few days.
However, some people may experience severe post-biopsy pain.
It is common with prostate biopsies.
This is evidenced by a 2021 study from China.
This is not to say that you should ask for someone to hold your hand during the procedure.
Most do not require medical treatment.
Can Prostate Biopsy Cause Erectile Dysfunction?
A 2021 review involving 54 published studies found no association between prostate biopsy anderectile dysfunction (ED).
Who Doesnt Need a Prostate Biopsy?
Anesthesia options include:
Once the area is amply numbed, the procedure can begin.
During the Procedure
TRUS and TPB are two options for a prostate biopsy.
Most urologists advise people not to drive themselves home due to the pain and lingering effects of certain anesthetics.
If a pudendal nerve block was used, you should not drive.
If you were prescribed antibiotics, you would take the second and final dose 12 hours after the procedure.
Sex should also be avoided for the first three days.
It is not uncommon for there to be traces of blood in your urine for up to 14 days.
If these symptoms worsen or you develop any new symptoms, call your healthcare provider.
When to Seek Medical Care
Severe infections following a prostate biopsy are rare but can occur.
The pathology report will describe all of the labs findings, including thehistological findingsseen under the microscope.
Additional action is needed if the pathology report returns anything but a negative result.
In some cases, even a negative result needs follow-up.
In such cases, your urologist may recommend a repeat prostate biopsy in 3 to 6 months.
Alternatively, you may be routinely monitored with blood, urine, and MRI tests.
The numbers from each section are then added up to get the final score.
These findings will help establish how aggressive the tumor is and what cancer treatments are most appropriate.
Not every case needs immediate treatment.
In some cases, a low Gleason score may warrant a watch-and-wait approach.
How Many Prostate Biopsies Are Cancer?
Summary
A prostate biopsy is performed when there is a suspicion of prostate cancer.
The outpatient procedure takes 15 to 30 minutes to complete, typically under local or regional anesthesia.
Side effects tend to be mild and transient.
Rectal pain and pain with urination tend to ease within several days.
Performing the MRI first reduces the risk of unnecessary biopsies while increasing the accuracy of prostate cancer screening.
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doi:10.1503/cmaj.190568
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doi:10.1136/bmjopen-2019-035887
Prostate Cancer UK.What are the side effects of a biopsy?
doi:10.1259/bjr/56357549
Canadian Cancer Society.Transrectal ultrasound (TRUS).
Memorial Sloan Kettering Cancer Center.About your prostate biopsy with ultrasound.
American Cancer Society.Your prostate pathology report: cancer (adenocarcinoma).
American Cancer Society.Tests to diagnose and stage prostate cancer.
American Urological Association.Clinically localized prostate cancer: AUA/ASTRO/SUO guideline.
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