Prostate biopsy: indications and practiced methods

Clarification of the nature of compactions and formations in the prostate is carried out using a morphological study, which requires a piece of tissue with altered cells.

To obtain the material, a prostate biopsy is required.

Such a procedure is now not particularly difficult due to the good quality of medical equipment, and complications after prostate biopsy are extremely rare.

Ultrasound-guided biopsy minimizes the invasiveness of the procedure and allows it to be carried out as efficiently as possible

Just a few decades ago, puncture biopsy of the prostate gland was performed in a “blind” manner, in which the procedure was controlled using a specialist’s finger. Today, the manipulation is carried out under the control of transrectal ultrasound (TRUS) or using an automatic biopsy device.

How to prepare for the procedure

Preparing for a prostate biopsy is not difficult.

Sometimes, for preventive purposes, at a preliminary consultation, a urologist may prescribe antibacterial drugs necessary to prevent various types of complications associated with inflammatory reactions.

Preparing for a prostate biopsy involves asking a man about allergies to certain medications, presence or absence of bleeding disorders, or taking medications that can change blood properties.

When a patient is taking blood thinners, for example, Warfarin, the decision about a prostate biopsy is agreed upon with the doctor who prescribed them

Before a prostate biopsy is performed, the patient must read the document, which indicates all the possible consequences, and sign. You also need to find out in advance how tissue collection is done.

If the prostate biopsy will be performed through the perineal tissue using local anesthesia, no preparation is needed.

Transrectal prostate biopsy, performed through the intestines, requires bowel cleansing with an enema. If the patient is very nervous, it is permissible to take a sedative the day before.

A few days or the evening before the procedure, you can take valerian tincture

Basic biopsy methods

Today, there are three ways to collect prostate tissue cells for further research:

Transrectal.
It is carried out when the man is in different positions: lying on his back (legs are placed on a stand), on his side, in a knee-elbow position. A biopsy of prostate cells is performed after an anesthetic is injected into the prostate area. Ultrasound monitoring is required. The biopsy needle has a spring device, thanks to which the collection of cells is carried out very quickly, taking only a few seconds. Transrectal biopsy of the prostate involves taking tissue from several areas of the prostate, which makes it possible to identify the nature of pathological cells with maximum reliability. The research is carried out in special laboratories. This type of biopsy is sometimes performed by using the doctor's finger to help feel the gland to insert the device through the intestinal tissue. For transrectal biopsy, a special device is used that allows you to monitor the process on the monitor of an ultrasound machine
Transperineal. This method is used less often than others. The patient is positioned on his side for a prostate biopsy, after preliminary anesthesia of the perineum, the doctor makes an incision on the anterior abdominal wall, which is necessary to insert a thin needle. It is carefully passed into the prostate and tissue is removed. In order to fix the gland, the doctor inserts a finger into the rectum.
Transurethral. To perform a prostate biopsy using this method, the man must lie on his back and place his legs on holders. Local anesthesia is usually used. A biopsy is performed using a flexible narrow probe with a lamp and a built-in video camera, as well as using a cutting loop. This procedure can take up to half an hour or more. Upon completion, you can sit and walk if the patient feels normal.

In the transurethral technique, a biopsy device is inserted through the urethra and urethra.

Pain and complications

The doctor should inform the patient at a preliminary consultation about what a prostate biopsy is and how painful it is. As a rule, such a procedure causes some discomfort, associated both with anxiety during preparation and with physical sensations.

After anesthesia, there may be discomfort when a special needle is inserted into the gland.

Transrectal multifocal biopsy to obtain prostate tissue may sometimes be accompanied by a feeling of pressure as the ultrasound probe is inserted into the intestine. A similar feeling occurs in the patient when the doctor’s finger is inserted into the rectum. There may also be some mild pain when the prostate biopsy device is inserted.

To reduce discomfort and pain during insertion of the sensor into the rectum, the patient should relax as much as possible

After the multifocal prostate biopsy is completed, the patient should not physically exert himself during the first 24 hours.

At this time, pain may occur in the pelvic area, and blood may be observed in the urine (hematuria). Within a week, a man may notice that the seminal fluid has changed in color.

If a prostate biopsy was performed using the transrectal method, consequences such as minor bleeding from the rectum are possible.

If the material was collected using general anesthesia, the patient is left in the medical facility for some time.

Doctors' supervision allows the patient to better tolerate the effects of general anesthesia.

Since the procedure is an invasive procedure, there is always a risk of the following consequences:

inflammatory process as a result of bacteria;
difficulty urinating due to bleeding in the urinary canal and hematoma;
bleeding in the intestinal tract during the first three days after the procedure;
allergy to drugs used for anesthesia.

Reasons for urgently contacting a urologist:

bleeding continues for more than three days;
hyperthermia is observed;

A sharp increase in temperature may indicate the development of inflammation in the prostate

severe pain appeared;
It is impossible to carry out the process of urination for 8 hours.

Indications for the study

A urologist prescribes an examination of prostate tissue if the following indications exist:

Detection of compacted areas during rectal diagnostics using a finger.
Such a study refers to auxiliary methods used to detect gland diseases. Palpation allows you to determine changes in volume and compaction in the prostate tissue, which is important if the development of neoplasms is suspected. A digital examination performed on all patients during a visit to a urologist allows one to assess the need for further examinations, including a biopsy.
Hyperechogenicity of areas of the prostate gland when examined using ultrasound. For diagnosis, a rectal sensor is used, which allows one to reliably determine the location of the compaction and size.
Increased prostate-specific antigen (PSA). Antigen levels increase with malignant prostate pathology. The PSA value can also increase in other diseases, so only a doctor should interpret the analysis correctly.

Diet after the procedure

The diet after a prostate biopsy does not imply any serious restrictions. However, it is recommended to adhere to a number of rules that help strengthen the immune system, prevent bleeding, constipation and increased gas formation in the intestines.

Drinking even low-alcohol drinks is harmful to men's health and the body as a whole.

After a saturation biopsy has been performed, it is advisable to completely eliminate the consumption of alcohol-containing drinks, as they contribute to excessive irritation of the mucous membranes of not only the digestive tract, but also the bladder and urethra, thereby causing discomfort when urinating. In addition, alcohol changes the properties of the blood, which can lead to bleeding.

Carbonated drinks containing large amounts of flavorings and dyes also worsen the condition of mucous membranes, reduce immunity. It is undesirable to drink coffee in the first week after the procedure, which is better replaced with healthy compotes and clean water. Some restrictions also apply to spicy foods. Beans, cabbage, and grape juice can increase flatulence.

The basis of the diet in the first weeks after the invasive procedure should be fruits, vegetables, cereals, and lean fish. During this period, you can eat nuts, citrus fruits, and white meat.

To avoid unnecessary overload of the digestive tract, portions should be small.

It is important to remember about the drinking regime (1.5 liters of water per day or more), compliance with which allows you to speed up the regeneration of damaged prostate tissue and prevent possible complications.

Light, low-fat meals are ideal for post-biopsy nutrition.

Intimate life

It is better to find out in advance what a prostate biopsy is and whether you need to prepare for it. It is also necessary to check with your doctor about restrictions in your intimate life.

Urologists recommend abstaining from sexual activity for a week after the biopsy, since the prostate gland is injured.

After seven days, a man can resume having sex if certain rules are followed:

it is necessary to stop taking stimulant drugs;
you should not try to delay the process of ejaculation;
Casual connections should be avoided.

Pain after sexual intercourse is a reason to consult a doctor

You should consult a urologist if pain occurs after sexual intercourse, the shade of the seminal fluid has changed, or your general condition has worsened.

The procedure for taking material for cytological analysis is currently not unduly traumatic for the prostate gland. Thanks to this method, it became possible to clarify the nature of tumors and carry out the most effective therapy.

It is better to find out where to do a biopsy from a urologist. The procedure is performed only after the main types of diagnostics have been carried out. It is advisable to find out how much a biopsy costs in advance.

You should not refuse the procedure if your doctor recommends such a study.

In the video, the patient talks about how he underwent a prostate biopsy:

Source: http://bolezni.com/stati-o-boleznyah/prostatit/biopsiya-predstatelnoj-zhelezy.html

How is a prostate biopsy done? Indications, preparation and methods

A prostate biopsy allows you to conduct a detailed analysis and, based on the results, clarify or refute the diagnosis.
If there is a possible prostate tumor and a sharp increase in the PSA level in the blood, the patient is prescribed a biopsy.

A prostate biopsy is a procedure in which a small amount of glandular tissue is removed. To obtain an accurate analysis, tissue samples are taken from different parts of the gland.

The biopsy sample is taken using a thin hollow needle. The resulting material is sent for subsequent laboratory tests. Using clinical markers, specialists assess the extent of the tumor, its growth pattern, aggressiveness and degree of differentiation.

Indications for surgery

The procedure is prescribed to patients who have been diagnosed with abnormal PSA levels in the blood. Indications for primary biopsy:

PSA increase to a level of 4 ng/ml;
dense areas or nodular formations in the gland area detected during palpation;
areas with reduced echogenic activity in the gland area identified during ultrasound;
control over the rehabilitation process after surgery to remove the gland or transurethral resection.

Indications for secondary analysis:

negative dynamics of PSA in the blood (increased or consistently high levels);
deviations in the ratio of two types of antigen (from 10%);
high antigen density (more than 15%);
prostatic intraepithelial neoplasia detected at the first biopsy;
failure of samples removed during the first biopsy.

Contraindications

The procedure is contraindicated in patients with unsatisfactory general condition of the body. The doctor may delay the analysis or refuse to perform a biopsy if the patient has pathologies that may prevent tissue healing:

low blood clotting;
inflammation of the rectum;
infectious lesions (general and local).

Preparation for the procedure

A person entering the hospital for a biopsy must sign papers confirming their consent to the minimally invasive procedure.
The attending physician, in turn, has a conversation with the patient, during which he explains how the biopsy is taken and what complications may arise during the rehabilitation period.
Preparation for analysis consists of several stages.

A week before the intervention, the patient must complete or interrupt the course of taking blood thinning medications. Three days before the procedure, you should not use non-steroidal anti-inflammatory drugs and hormonal drugs.
Prescription of antibacterial agents to exclude the possibility of infectious infection (the day before the biopsy). After taking a biopsy, antibacterial prophylaxis lasts another 4–6 days.
Examination of the body using laboratory and instrumental techniques.
Test for tolerance to painkillers (consultation with an anesthesiologist when prescribing anesthesia).
Prescription of hemostatic drugs 10 days before puncture (if indicated).
Cleansing the intestines through an enema of fecal matter during transurethral and transrectal biopsy.

Self-preparation of the patient consists of refusing food and liquid 8–12 hours before surgical procedures (subject to intravenous anesthesia) and refusing coarse fiber foods in favor of a light breakfast (subject to local anesthesia). The evening before the examination, the patient should take a shower.

ATTENTION! If a person experiences increased anxiety, the day before the procedure, you can take a sedative prescribed by your doctor.

Methods for performing the procedure

To detect prostate cancer, three methods of taking biopsy samples are used:

sextant (material is collected from 4–6 points of the pathological area, through access in the lumen of the rectum, controlling the procedure by palpation);
polyfocal (biopsy material is taken from 12 points, monitoring the process using an ultrasound machine);
saturation (a biopsy is taken from 24 points, monitoring the process using an ultrasound machine).

The technique involves taking a biopsy sample under the control of an ultrasound machine and the doctor’s finger. The patient can be on his side, in the knee-elbow position, or on his back (with his legs fixed on a stand).

The surgeon uses a spring needle, which allows for sampling quickly and efficiently, taking up to 10 samples of gland tissue.

The average duration of the procedure varies depending on the monitoring method. With ultrasound control, the intervention lasts only a couple of minutes, and with a blind study using the palpation method, up to 30 minutes.

The surgeon uses a cystoscope and a loop instrument, which is inserted into the patient under general anesthesia or anesthesia. The patient is placed on his back, his legs are fixed on supports.

After this, an endoscopic device with a camera and a lighting element is inserted through the urethra. The device is inserted to the depth required for the loop to contact the prostate and a biopsy sample is taken. The procedure takes from 30 to 45 minutes.

The patient is positioned on his back or side, with his legs pressed to his chest. The procedure takes place under general anesthesia or general anesthesia.

The doctor creates a small surgical access in the perineum and inserts a needle to collect prostate tissue, controlling the movements of the instrument using an ultrasound machine. The manipulations last from 15 to 30 minutes; after tissue sampling is completed, the incision is sutured.

Possible consequences

Before the puncture, the patient is notified that complications may arise:

sepsis;
dysfunction of urination (temporary dysfunction associated with swelling of the prostate);
hematuria and hemospermia (the appearance of blood in biological fluids);
progression of malignant processes (the risk of active restoration of damaged cancer cells is minimal).

ATTENTION! Regardless of how the biopsy is taken, intimate life can be resumed no earlier than 7–10 days after the procedure. During this period, you should stop drinking alcohol and nicotine and avoid exposing your body to thermal effects.

The procedure is performed on an outpatient basis if indications do not require transferring the patient to a continuous monitoring regime (taking medications from the list of medications prohibited before a biopsy). Therefore, after the biopsy, the patient leaves the clinic, and after 6–14 days comes to see a specialist and receives a conclusion.

Classification of results

PIN (PIN indicator is an indicator of the probability of detecting cancer at repeated punctures after 0.5–3 years);
malignant tumor (biopsy samples contain cancer cells);
benign tumor (the malignant diagnosis is refuted, and the patient is referred for drug treatment of the benign neoplasm).

Confirmed malignancy is graded according to the Gleason score. The scale reflects the degree of damage to the gland (5-point gradation).

Source: https://MedOperacii.com/mps/biopsiya-predstatelnoj-zhelezy.html

How to do a prostate biopsy

If prostate cancer is suspected or to exclude oncology during the examination, the doctor may give a referral for a prostate biopsy. This is a diagnostic method during which a part of the organ tissue is taken with a special needle for examination.

Let's look at how a prostate biopsy is done and how to prepare for it. We will also provide information about possible complications and what a man should do after the manipulation.

What biopsy method is used?

There are only two known methods by which you can take a piece of tissue for subsequent research without resorting to abdominal or endoscopic operations.

The first of them is transperitoneal - needles are inserted through the skin in the perineal area.

This method has many disadvantages, requires serious premedication, causes dangerous complications, and therefore is practically not used in modern urology.

Transrectal biopsy is much better tolerated by men, during which it is possible to precisely remove prostate tissue from the desired areas and cause less harm to the patient’s body. All manipulations are carried out under the control of ultrasound equipment, there is less tissue injury, and the man himself recovers faster. There are significantly fewer complications with the transrectal biopsy method.

In modern diagnostics, preference is given to transrectal multifocal biopsy.

List of indications for biopsy

There are certain diagnostic signs that may indicate prostate cancer. This can be TRUS or MRI data, and the results of a blood plasma test for PSA - a prostate-specific antigen that increases during cancer and other processes.

Therefore, indications for prostate biopsy are:

An increase in PSA level above the age norm.
Presence of prostatic intraepithelial neoplasia (PIN).
Detection of questionable areas in the prostate during TRUS or MRI.
Increase in PSA level after the initial biopsy.
Suspicion of tumor formation after prostate resection.

Without a prostate biopsy, it is very difficult to confirm or deny the presence of cancer in the organ. However, the technique itself can be dangerous, and therefore it is done only if the listed indications are present.

How to prepare for a biopsy

Knowing the patient's medications is important when preparing for a biopsy. Many of them can distort the test result or cause severe bleeding, so they should be canceled.

3 days before the scheduled date, medications that affect blood composition are discontinued:

Warfarin;
Aspirin;
Cardiomagnyl and others.

If it is impossible to cancel them, for example due to problems with the heart or blood vessels, a biopsy can only be done in a hospital setting with subsequent monitoring for possible bleeding.

In order to prevent possible complications, the doctor collects information that can be used to judge blood clotting. For example, questions may be asked about how long bleeding lasts after a tooth extraction or whether light blows cause extensive bruising. If such problems exist, the biopsy will be performed with the greatest precautions; perhaps in an inpatient setting rather than an outpatient setting.

For 3 days, also stop taking various anti-inflammatory drugs, even if they are prescribed for the treatment of prostatitis. Ibuprofen, Ortofen, Diclofenac, Indomethacin and other drugs are prohibited. Their use can be resumed no earlier than 3 days after the prostate biopsy, if there are no complications and only with the doctor’s permission.

A man must also:

do a cleansing enema the night before;
take a shower;
Have breakfast on the day of the biopsy.

In some cases, taking biomaterial through the wall of the rectum is possible without a cleansing enema, but feces will interfere. Therefore, it is better if the intestines are cleansed.

Failure to comply with these measures may cause complications or make the biopsy impossible.

How is a prostate biopsy performed?

In most cases, hospitalization is not necessary; the biopsy is performed on an outpatient basis during a transrectal examination of the prostate. Hospitalization is possible only if indicated.

The procedure itself is carried out approximately in the following sequence:

The man lies down on a special couch on his left side. It is believed that this position is most comfortable for the subject.
The doctor conducts a digital examination of the prostate, while simultaneously lubricating the anus with a special composition that facilitates the insertion of instruments.
A condom is placed on the scanner and lubricant is applied.
The device is inserted into the rectum, using ultrasound, the prostate is examined and the foci of the pathological process are determined.
Using a needle, the wall of the rectum is pierced and part of the prostate tissue is removed.

The resulting material is sent for histological examination to the laboratory.

For many men, especially those with prostate inflammation, the procedure can be painful. Therefore, a biopsy is done after local anesthesia. For this purpose, a lubricant with lidocaine or injections of painkillers can be used.

A few hours after the biopsy is taken, the man will be able to eat. Particular attention is paid to the drinking regime: if there are no contraindications, on the first day you need to drink at least 2.5 liters of water.

Possible contraindications to biopsy

A biopsy refers to invasive interventions in which, although slightly, the integrity of the tissue is disrupted. This can lead to changes in the functionality of certain organs, increases the risk of infection, and therefore the technique is contraindicated in the following cases:

acute prostatitis and chronic in the acute stage;
hemorrhoids that occur with complications;
anal stricture;
bleeding disorders;
acute infectious processes.

Prostate adenoma, prostate tuberculosis and chronic prostatitis are not contraindications. On the contrary, in many cases, a biopsy becomes the only method that allows one to exclude oncology or, conversely, to detect it.

If the technique is followed, prostate biopsy is considered a relatively safe method.

Potential Complications

No matter how careful and competent the doctor is, there is always a risk of complications. It increases if a man neglected the doctor’s recommendations in the preparatory and rehabilitation period, as well as in the presence of certain diseases.

The most common complication is bleeding. Moreover, blood can appear in drops from the rectum and be noticeable on underwear, or it can get into physiological fluids - urine or semen. There is also a high probability of the onset of acute prostatitis and pain in the perineal area.

Other complications that occur less frequently:

orchiepididymitis - inflammation of the testicles and their appendages;
loss of consciousness;
urinary retention.

Some men may lose consciousness during the biopsy or shortly after. This is due to the peculiarities of the psyche - for many, the very thought of inserting a needle inside already seems so terrible that you can feel sick. For this reason, the person being examined is left on the couch for half an hour after the biopsy.

It is not recommended to drive a car for a couple of hours after the examination.

It is important that multifocal transrectal biopsy is performed using aseptic technique and rules, and that the doctor has sufficient experience in this field. Therefore, to take a biopsy, it is better to contact specialized medical centers, having previously studied the reviews. With this approach, the likelihood of complications will be much lower.

Recommendations for rehabilitation

After a biopsy, you need to follow certain rules that will help you recover faster and avoid complications. Usually the doctor gives a reminder to patients on the day of the examination, but you can also use our mini-instructions:

Do not swim in open water or swimming pools for a month;
if possible, take a shower instead of a bath;
do not go to baths and saunas;
ensure that there is no hypothermia, do not sit on cold surfaces;
do not play sports, do not ride a bicycle;
try to avoid physical activity;
do not drink alcohol and coffee.

These restrictions are valid for a month from the moment the biopsy is taken. However, it is better to give up alcohol completely. In addition, for the first week you need to drink 2.5 liters of liquid daily, including juices from freshly squeezed berries and fruits.

Sex is prohibited for two weeks unless otherwise directed by your doctor.

Conclusion

Multifocal transrectal biopsy is a highly effective and relatively safe method for detecting prostate cancer. Manipulations are carried out through the rectum under ultrasound control. The procedure is well tolerated by men and has few contraindications and complications. It is important to follow lifestyle recommendations during the rehabilitation period.

Prostate biopsy, indications and methods of the procedure

Preparation
Kinds
results

A prostate biopsy is currently the only way to definitively diagnose prostate cancer.
It also helps differentiate a cancerous tumor from benign prostatic hyperplasia or globular enlargement of the prostate (a very common condition in middle-aged and older men), which requires a different treatment approach than cancer.
A prostate biopsy may be prescribed in the following cases:

If the doctor finds a nodule or other abnormality during a digital rectal examination.
This procedure is also indicated when a blood test shows elevated levels of prostate-specific antigen, although there are several reasons for elevated PSA levels: Higher levels are sometimes associated with cancer. A tendency for PSA levels to increase over time may prompt the urologist to order a biopsy for the patient.

A biopsy not only detects cancer; it also provides information about the aggressiveness of the disease and helps the doctor make the right decision regarding treatment tactics.

Minimally invasive prostate biopsy can be aspiration (fine needle) without the use of ultrasound technology, but it is most effectively carried out under ultrasound guidance. This technique is known as transrectal ultrasound (TRUS). The average price for this service in Moscow is 20,200 rubles.
A prostate biopsy can also be performed using information from MR imaging, which provides more detailed images of the prostate compared to ultrasound.
Finally, MR imaging images can be fused in real time with ultrasound images—MRI/TRUS fusion biopsy.

Benefits of prostate biopsy:

It is carried out on an outpatient basis.
Helps accurately diagnose prostate pathologies and speed up the initiation of appropriate treatment.
A biopsy helps differentiate between prostate cancer and prostate adenoma.
Recovery time after biopsy is taken is short and patients can soon resume their normal activities.

How is transrectal ultrasound biopsy performed:

Half an hour before the procedure, an enema is performed to cleanse the rectum of feces. Thanks to this, the prostate will be better visible and the risk of infection will be reduced.
Sometimes the doctor will inject a local anesthetic or sedative into the rectal area to minimize discomfort during the procedure.
During the procedure, the patient will be asked to lie on their left side, with their legs bent.
The doctor first performs a digital rectal examination with a gloved finger.
A hollow ultrasound probe will then be inserted into the patient's rectum. The probe is first sterilized, a condom is put on to provide protection from any infection, and lubricated to help it slide easily down the rectum. A small hollow needle is passed inside the probe.
With continuous ultrasound imaging, the physician can view the needle's progress in real time.
Typically, 6 to 14 samples are taken during the procedure, after which the probe is removed.
Then the patient is under medical supervision for some time to prevent possible complications of the prostate biopsy.
The entire TRUS procedure is usually completed in 30 minutes or less.

Perineal biopsy method:

The patient is asked to lie on his left side or back, with his knees bent and hips apart.
The skin between the scrotum and rectum is cleaned with an antiseptic solution.
The patient is given a local anesthetic, which may cause a brief tingling sensation.
Once the treated area is numb, the doctor makes a tiny incision in the skin.
The doctor places a gloved finger into the patient's rectum to locate and stabilize the prostate gland.
A needle biopsy is done using a syringe and a thin, hollow needle passed through an incision several times to take samples from different parts of the gland. To better control the perineal biopsy process, the procedure is often performed using a CT scanner or magnetic resonance imaging scanner.
After this procedure, stitches are usually not required.
The resulting biopsy will be sent to the laboratory for histological analysis.

Transurethral prostate biopsy method:

The patient is positioned on his back with his knees bent and hips apart. The procedure can be performed under local or general anesthesia.
The doctor will insert a cystoscope (flexible tube) into the opening at the end of the patient's penis and guide it through the urethra to the prostate gland. Using tiny instruments inserted through a cystoscope, samples of the prostate gland are taken. Then the cystoscope is removed, and the samples will be sent to the laboratory, where a conclusion will be given whether there are cancer cells in the biopsy or not.

You should stop or limit the use of blood thinning medications 7 to 10 days before your procedure to prevent excessive bleeding during and after the biopsy. A blood test may be required on the day of the procedure to check blood clotting.

Preparation for a prostate biopsy includes antibiotics (immediately before the procedure) as additional protection against infection, as well as medications for pain and anxiety.

Those undergoing an MRI-guided biopsy will be asked to remove any metal objects, such as jewelry, watches, and hearing aids. In this case, it is important to tell your doctor about metal implants such as pacemakers.

The diet the day before and on the day of the biopsy includes only light snacks. The patient may also be offered an enema.

For those who intend to be sedated or undergo anesthesia during the procedure, it is advisable to have a relative or friend assist you with a ride home after the biopsy.

Contraindications to prostate biopsy:

excessively severe health condition;
infectious diseases in the acute stage;
bleeding disorders that cannot be controlled;
acute inflammatory processes in the rectum;
acute prostatitis;
severe hemorrhoids.

Prostate biopsy is generally safe. Risks and complications include:

Infection.
Problems with passing urine.
Allergic reactions to medications.
Bleeding or bruising at the biopsy site.
Blood in semen or stool (usually disappears after a while).
You can have sex a week after the procedure.

Transrectal prostate biopsy under digital control (performed with a needle gun) or transrectal multifocal prostate biopsy under ultrasound control is the most common and therefore accessible method.

Its cost in Russian clinics starts from 6,000 rubles. Histological examination comes at a separate price - from 2 to 7 thousand rubles.

A biopsy spring needle for taking a biopsy from 6 points or more (usually from 14 to 20) is inserted not through the perineum, but anally, under the control of transrectal ultrasound scanning. This method avoids hospitalization and does not require general or local anesthesia. This reduces the cost of the study and avoids the risks associated with anesthesia.

Other methods of prostate biopsy are used, but not very often. These include:

Transurethral - through the urethra. The use of spinal, local or general anesthesia allows you to avoid pain. This method is indicated for diagnosing prostate cancer when it is necessary to obtain a large volume of biopsy. For example, to differentiate prostate cancer stages T0a and T0b after a previous puncture biopsy of the prostate revealed stage T0. Price - from 15,000 rubles.
Perineal puncture biopsy of the prostate or transperineal approach through the perineum. This method may be used for one of the following reasons:
1. if cancer is suspected in the anterior part of the gland, too far from the rectum for TRUS;
2. if transrectal ultrasound is not possible due to previous rectal surgery.
This method avoids contact of the needle with the rectum, reducing the risk of infection. With the transperineal method, a large amount of biopsy can be taken, and this makes it possible to detect or exclude the presence of malignant cells with a high degree of probability. Price - from 10,000 rubles.

The doctor will receive the results of the biopsy a few days after the procedure. The time required to decipher and interpret results may vary depending on the complexity of the analysis, the need to consult with another specialist, and other factors.

Positive prostate biopsy results mean that cancerous cells have been found.

The lab will grade the cells according to the Gleason score, which helps predict how quickly the cancer will grow.

A biopsy may also show cells that look abnormal but do not necessarily indicate cancer. In this case, a repeat biopsy may be required.

Source: http://prostatitoff.net/diagnostika/biopsija-prostaty/

Prostate biopsy: how it is performed, indications, consequences

A prostate biopsy makes it possible to timely identify tumor processes in the gland, conduct histological diagnosis 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 of this is due to early and reliable diagnosis using biopsy. During this procedure, using special instruments, the doctor takes samples of gland tissue for subsequent histological examination.

This is a low-traumatic procedure that is fairly quick and painless for the patient and is highly accurate and informative.

Methods for performing a biopsy

Various techniques are used to perform a biopsy, the main differences being in the way tissue samples are taken and the instruments and equipment used. The most common methods are the following:

Multifocal transrectal biopsy . The patient first receives local anesthesia, after which the doctor uses a special needle to collect gland tissue. The examination is performed through the rectum, and control is provided using an ultrasound machine. The manipulations last 3-5 minutes. The needle used during the examination quickly enters and exits the gland, allowing up to ten tissue samples to be taken
Transurethral biopsy . The examination is carried out through the urethral canal. To perform such a biopsy, an endoscope and a special instrument – a cutting loop – are used. Pain relief can be carried out either locally or, in some cases, using general anesthesia. The endoscopic device has a video camera and lighting, thanks to which the doctor visually monitors its movement. Having penetrated through the urethra to the level of the prostate, the doctor collects 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 procedure is about half an hour.
Transperineal biopsy . The procedure is performed through an incision in the perineum. This method is the least popular due to the relatively high level of pain for the patient, as it involves making an incision in the perineum. Pain relief is carried out using local anesthetics or general anesthesia. Through the incision, the doctor collects gland tissue with a special needle, moving it under the control of an ultrasound machine. At the end of the procedure, stitches are placed on the incision

Indications for the procedure

The primary indications for the procedure are the following:

Presence of lumps or nodules in the gland that are palpable during rectal examination
Increased level of PSA (prostatitis-specific antigen) in the blood
Presence of a zone with low echogenicity according to ultrasound results
The need for disease control in patients undergoing prostate resection or removal

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

The biopsy may be repeated if the following indications exist:

Maintaining or increasing PSA levels in the blood
High antigen density
Violation of the relationship between the levels of free and total antigen
Obtaining insufficient tissue volume during the initial biopsy for research

Whether a prostate biopsy is necessary, how the procedure is performed and other nuances, you can check with a 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
Bleeding disorders
General serious condition
Period of acute infectious disease

If the patient has ARVI and other diseases that prevent a biopsy, the doctor may suggest waiting for the patient’s health to normalize in order to exclude the influence of extraneous factors on the result of the study. To perform a biopsy, the patient's permission for the procedure is required; if it is absent, the biopsy is not performed.

How to properly prepare for a biopsy procedure

Proper preparation for the biopsy procedure is important to obtain the most accurate result possible. A week before the test, it is important to do the following:

Do not take drugs that change the structure of the blood
Do not take anti-inflammatory drugs 3 days before the procedure
Start taking antibacterial medications five days before the procedure to prevent inflammation of the prostate
Follow a diet the day before the test and eat only easily digestible foods

If it is not possible to stop taking medications, a biopsy is performed only in a hospital setting. To exclude inflammatory processes, laboratory tests are prescribed before taking tissue samples. If the patient is undergoing anesthesia, a preliminary anesthetic test is performed.

The evening before the examination, as well as in the morning on the day 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 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 either on an outpatient basis or in a hospital setting. For pain relief, local anesthesia is most often used, in which case the procedure is performed on an outpatient basis.

If general anesthesia, spinal or epidural anesthesia is required, and also if the patient’s condition requires more serious medical supervision, the study is performed after hospitalization in a hospital, where the patient spends from several hours to two days after the procedure.

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

Possible consequences of the procedure

If the patient follows the rules of preparation and the specialist performs the manipulations correctly, the likelihood of complications developing is minimal. The main risks during and after manipulation are the following factors:

Infection. This risk occurs when an endoscope is inserted into the urethra.
Traumatization of mucous membranes . A feature of the urethra in men is the presence of two functional bends, when passing through which the instrument may cause minor injuries to the mucous membranes
Development of bleeding. Damage to blood vessels is possible directly during the collection of tissue samples for research in patients with large adenomas

What to expect after the procedure

The biopsy procedure is well tolerated by most patients, and unless general anesthesia or spinal or epidural anesthesia was used, you can go home immediately after the test. If anesthesia is used, the patient may be asked to stay in a medical facility for some time to monitor his condition.

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

A gentle regime of physical activity . During increased physical activity, there is a possibility of pressure on the prostate of other organs, which can lead to bleeding at the sites where the material is taken, and, as a result, to the formation of an encysted hematoma
Cold compress. Ice applied to the lower abdomen causes blood vessels to contract, which reduces the risk of bleeding
Antibiotic therapy. After the procedure, you may need to take antibiotics to help prevent infection.

Advantages of performing a prostate biopsy procedure at MEDSI

At MEDSI clinics, high standards are observed when performing prostate biopsies. This procedure is performed by an experienced urologist using an ultrasound machine, which makes it possible to identify suspicious areas of tissue as accurately as possible. The MEDSI network offers clients in need of a prostate biopsy: