Prostate biopsy how it is performed, indications, consequences

Prostate biopsy

A biopsy of the prostate gland makes it possible to timely identify tumor processes in the gland, conduct histological diagnostics and determine the most effective treatment regimen for the patient.

 

More than 80% of patients diagnosed with early stage prostate cancer are successfully cured, and much credit for this belongs to early and reliable diagnosis performed using a biopsy. During this procedure, using special instruments, the doctor takes samples of the gland tissue for subsequent histological examination.

 

This is a low-traumatic procedure that is fast enough and painless for the patient and has high accuracy and information content.

 

 Biopsy methods 

Various techniques are used to conduct a biopsy, the main difference between which is in the method of taking tissue samples and the instruments and equipment used. The most common methods are:

 

  • Multifocal transrectal biopsy . Previously, the patient receives local anesthesia, after which, using a special needle, the doctor takes the tissue from the gland. The study is performed through the rectum, and control is provided using an ultrasound machine. In this case, manipulations last 3-5 minutes. The needle used during the study quickly enters and exits the gland, allowing up to ten tissue samples to be taken

  • Transurethral biopsy . The study is carried out through the urethral canal. To perform such a biopsy, an endoscope and a special instrument, a cutting loop, are used. Anesthesia can be carried out both locally and in some cases with the help of general anesthesia. The endoscopic device has a video camera and illumination, thanks to which the doctor makes a visual control of its movement. After penetrating the urethra to the level of the prostate, the doctor draws tissue samples with a loop. This method allows you to visually identify the most suspicious areas in the gland and take a targeted biopsy. The duration of the manipulation is about half an hour.

  • Transperineal biopsy . The procedure is performed through an incision in the perineum. This method is the least popular because of the rather high level of pain for the patient, since it involves performing an incision in the perineum. Pain relief is carried out with local anesthetics or general anesthesia. Through the incision, the doctor takes the tissue of the gland with a special needle, moving it under the control of an ultrasound machine. At the end of the procedure, stitches are applied to the incision

 Indications for the procedure 

The primary indications for the procedure are as follows:

 

  • The presence of seals or nodes in the gland, palpable during rectal examination

  • Increased PSA (prostatitis-specific antigen) levels in the blood

  • The presence of a zone of low echogenicity according to the results of ultrasound

  • The need to control the disease in patients with resection or removal of the prostate

Biopsy refers to invasive research methods, but its importance in identifying diseases of the prostate gland can hardly be overestimated - modern medicine has no alternative to this manipulation at the moment.

 

The biopsy can be repeated if the following indications are present:

 

  • Maintaining or increasing PSA levels in the blood

  • High antigen density

  • Impaired balance between free and total antigen levels

  • Obtaining insufficient tissue volume during the primary biopsy for research

Whether a prostate biopsy is necessary, how the procedure is performed and other nuances, you can check with the urologist at MEDSI.

 

 Contraindications 

A prostate biopsy is not performed in a number of cases, which include:

 

  • Acute stage of prostatitis

  • Proctitis complicated by hemorrhoids in the acute stage and other diseases of the rectum

  • Blood clotting disorders

  • General serious condition

  • Period of acute infectious disease

If the patient has ARVI and other diseases that interfere with the biopsy, the doctor may suggest waiting for the normalization of the state of health in order to exclude the influence of extraneous factors on the study result. To conduct a biopsy, the patient's permission for the procedure is mandatory, if it is absent, the biopsy is not performed.

 

 How to properly prepare for your biopsy procedure 

Proper preparation for your biopsy procedure is important to get the most accurate result possible. It is important to do the following a week before the study:

 

  • Do not take drugs that change the structure of the blood

  • Do not drink anti-inflammatory drugs 3 days before the procedure

  • Start taking antibacterial agents five days before the procedure to prevent inflammation of the prostate

  • Follow a diet on the day before the study and eat only easily digestible foods

If it is not possible to cancel the drugs taken, the biopsy is performed only in a hospital setting. To exclude inflammatory processes, laboratory tests are prescribed before taking tissue samples. If the patient is to be anesthetized, an anesthetic test is performed first.

 

In the evening on the eve of the study, as well as in the morning of the procedure, cleansing enemas should be performed to empty the rectum, since the biopsy is performed with an empty intestine. The study is carried out in the morning, in the case of general anesthesia - strictly on an empty stomach.

 

 Where is the biopsy procedure performed? 

Prostate biopsy is a low-traumatic procedure that can be performed both on an outpatient basis and in a hospital setting. For anesthesia, local anesthetics are most often used, and in this case, the procedure is performed on an outpatient basis. If general anesthesia, spinal or epidural anesthesia is required, as well as if the patient's condition requires more serious medical monitoring, the study is performed after admission to the hospital, where the patient spends from several hours to two days after the procedure.

 

MEDSI clinics offer comfortable conditions for biopsy, proper medical supervision and full adherence to the protocol of the procedure, which ensures high accuracy and efficiency of the study.  

 Possible consequences of the procedure 

If the patient observes the rules of preparation and the correct execution of manipulations by a specialist, the likelihood of complications is minimal. The main risk during and after manipulation lies in the following factors:

 

  • Infection. This risk arises when the endoscope is inserted into the urethra.

  • Injury to the mucous membranes . A feature of the urethra in men is the presence of two functional bends, during the passage of which the instrument may cause minor injuries to the mucous membranes

  • Development of bleeding. Damage to blood vessels is possible directly during tissue sampling for examination in patients with large adenomas

 What to expect after your procedure 

The biopsy procedure is well tolerated by most patients, and if general anesthesia or spinal or epidural anesthesia has not been applied, you can go home immediately after the examination. In the case of using anesthesia, the patient may be offered to stay in a medical institution for a while to monitor his condition.

 

To prevent the appearance of complications - bleeding, hematoma - the doctor may recommend the following measures:

 

  • Gentle physical activity . During increased physical activity, there is a likelihood of pressure on the prostate of other organs, which can lead to the release of blood at the sites of sampling, and, as a result, to the formation of an enclosed hematoma

  • Cold compress. Ice applied to the lower abdomen causes vasoconstriction, which reduces the risk of bleeding

  • Antibiotic therapy. After the procedure, it may be necessary to take antibiotics to help prevent infection.

 Benefits of having a prostate biopsy at MEDSI 

Medsi clinics adhere to high standards of prostate biopsy. This procedure is carried out by an experienced urologist using an ultrasound machine, which makes it possible to identify suspicious tissue areas as accurately as possible. The MEDSI network offers clients in need of a prostate biopsy:

 

  • The latest equipment to control the manipulation

  • High level of qualifications of specialists

  • Effective anesthesia for pain relief

  • Hospital and polyclinic conditions for the procedure