Prostate biopsies are the process of taking small amounts of tissue from the prostate for testing. It is a common way of diagnosing prostate cancer. They can be done three ways, with the most popular being the transurethral biopsy because it requires no incisions or insertion into the penis.
Prostate
The prostate, a small walnut shaped gland located on the male urethra, is responsible for secreting nutrients during ejaculation to aid in reproduction. The prostate is present a birth but does not begin to form until male puberty, spurred on the by the production of male hormones. It continues to grow until about age 20. It experiences another small growth spurt after age 40. This is also the age that you should begin to have regular prostate exams to monitor the health of this gland.
Reasons for Prostate Biopsy
Your health care provider will suggest a prostate biopsy for two reasons. The first is that during a prostate exam, he may have noticed an unusual growth on your prostate. High prostate-specific antigen (PSA) levels in your blood can also cause your health care provider to suggest a prostate biopsy. Prostate-specific antigen is a substance that your prostate releases in your blood. While low PSA levels do not necessarily mean that you are unhealthy, high levels can mean that your prostate has been enlarging. A suddenly enlarged prostate or an abnormal growth on your prostate can be signs of prostate cancer.
Preparation
An urologist, a health care provider specializing in male genital and urinary health, will perform your prostate biopsy. Before your prostate biopsy, he will ask you about your general health to prevent any problems during the procedure. Be as honest as possible and be especially sure to inform him of any medications you are taking. In most cases, your health care provider will also tell you to not have any food for up to six hours before the procedure. Clear liquids are OK for a bit longer but all liquids should be stopped at least two hours before the procedure. About an hour before the procedure starts, you will receive an intravenous line of sedatives to prepare you for the biopsy. Follow all preparation directions your health care provider gives you to avoid any surgery complications.
Transrectal Prostate Biopsy
There are several ways to perform a prostate biopsy. If you are having a transrectal prostate biopsy, you may be asked to kneel, lie on your side or lie back with your feet in stirrups. Your urologist will sterilize the area to avoid an infection and use a local anesthetic to numb it. Using a spring loaded needle guided by a transrectal ultrasound, the urologist will enter your prostate and remove a tissue sample. The urologist may also attach a needle to his finger, insert it into your rectum and take the tissue sample that way. Either way, he will take between six and 12 samples. The entire procedure will take about 30 minutes.
Transurethral Biopsy
Another way to reach the prostate is through the urethra. If your urologist does your biopsy this way, he will ask you to lie back and rest your feet in the stirrups. He will anesthetize you with a local, spinal or general anesthetic, depending on his or your preferences. Next, he inserts a lighted scope with a cutting loop into your urethra's opening at the head of your penis. The cutting loop allows him to remove tissue for the biopsy. This procedure will take 30 to 45 minutes.
Transperineal Biopsy
The final method of prostate biopsy is done through perineum, the area between your scrotum and penis. Your urologist will ask you to lie either on your side or on your back with bent knees. He will then give you general or local anesthesia. Then he makes an incision in your perineum. Then, while inserting a finger in your anus to hold the prostate gland in place, your urologist will insert a need through the incision into your prostate gland. After he has the tissue samples, he then puts a bandage over the incision. The whole thing takes no longer than 30 minutes.
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