TRANSPERINEAL BIOPSY OF THE PROSTATE GLAND

Transperineal biopsy is performed to determine if there is cancer present in the prostate gland. The procedure is performed under a general anaesthetic as a day surgery procedure. Under anaesthesia, an ultrasound probe is placed in the rectum, as shown, to visualise the prostate.  A perforated grid (template) is then placed against the perineum (the area of skin in males between the scrotum and the anus) and this is used to direct the biopsy needle into different parts of the prostate under ultrasound guidance.

• About 30-50 small “cores” of prostate tissue are taken from different areas of the gland. These specimens are then sent to a pathologist for examination.
• If there is a significant cancer present, a transperineal biopsy is approximately 90-95% accurate in finding it. However, because it is a sampling process, it is possible that a tiny area of cancer may be missed on a biopsy. However, ongoing surveillance will usually pick up any undetected cancer when it is still at an early stage.
• After the biopsy, you will be able to go home once you are awake, and have passed some urine. There isn’t usually much pain after the procedure but you can feel some discomfort or bruising between your legs. It is normal to see blood in the urine and semen (ejaculate) after a biopsy.
• Serious infection requiring admission to hospital can occur as a result of a trans-perineal biopsy, but the risk is very low (less than 1 in 1000 men).
• Very occasionally, some patients may experience an inability to pass urine after a biopsy, and may require a temporary urinary drainage tube (catheter).
• You should advise Dr Patel if you are taking any medications that can thin the blood (anticoagulants or antiplatelet drugs) or cause increased bleeding.

ADVICE AFTER PROSTATE BIOPSY

• You can eat and drink as normal.
• You should not drive a car for 24 hours after a biopsy, and you should avoid any strenuous activities or heavy lifting for 3-4 days after your biopsy.
• If you have been asked to stop any medication(s) prior to the biopsy (see above) please ask Dr Patel when it is safe to restart it.
• Blood or brownish discoloration will be in your semen for up to 6-8 weeks after a biopsy.
• It can take about 20 ejaculations before the semen looks clear again.  However, this is not dangerous and it is quite safe to continue your normal sexual activities with no increased danger to your partner.
• It is normal to see a small amount of blood when you pass urine for up to 1-3 weeks after the biopsy. Usually this is at the beginning or at the end of passing urine.
• If you feel unwell in any way or have any heavy bleeding after leaving hospital, you should either contact Dr Patel’s office, or the hospital where you had the procedure, so that Dr Patel can be notified.
• Please make sure that you have made arrangements with Dr Patel to find out your biopsy results.