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A prostate biopsy is a test which is done in order to take small samples of tissue from the prostate, which are then looked at in more detail and analysed.
There are generally two types of prostate biopsy. The first is called TRUS (trans-rectal ultrasound) guided biopsy. First, an ultrasound probe is inserted into the rectum, to allow imaging of the prostate. After this, a biopsy needle is inserted and samples are taken. On average, around ten samples are taken using this method.
The second type of prostate biopsy is called a transperineal (template) biopsy. In this method, more samples are taken from different areas of the prostate. Around thirty to fifty samples may be taken using template biopsy. An ultrasound probe is inserted into the rectum, and imagine is used to correctly guide the needle. In template biopsy, the needle is inserted into the prostate through the skin between the testicles and perineum.
Prostate biopsies are done in order to check for the presence of prostate cancer. Template biopsy is typically performed in those who have health concerns which do not permit a TRUS biopsy, or if a TRUS biopsy has been taken but the doctor suspects that prostate cancer is still present.
There is no specific preparation needed, but as a template biopsy is performed under general anaesthetic, making arrangements for someone to take you home after the procedure is advised.
If you are having a TRUS biopsy, local anaesthetic is used, meaning the area is numbed. The procedure may feel a little uncomfortable despite this, as you lie on your side with your knees raised towards your chest. A gel is used while inserting the probe in order to make the process easier. The procedure only takes around 10-15 minutes. You may feel some discomfort in your rectum after the procedure and in the days directly afterwards.
In a template biopsy, general anaesthetic is used, meaning you will not be conscious for the test itself. The test takes around 20-40 minutes, and you will have to stay at the clinic for a few hours afterwards to recuperate from the anaesthetic.
After the biopsy, the samples will be sent off to be studied. Each sample will be analysed to see if they contain cancer, and how much cancer is present in each one. If cancer is found, your doctor will be able to tell you how aggressive the cancer is, and if it is likely to spread. They will also be able to tell you the type of cancer, if it is present.
If cancer is found, your doctor will explain to you what the results mean, and what the next steps are for treatment.
If cancer is not found, but your doctor suspects that prostate cancer is present, they may order further tests or another biopsy.
Developments in medicine mean that biopsies become more targeted, and the need for frequent biopsies is greatly reduced. Prostate MRI can be used in order to detect prostate cancer, and if a biopsy is necessary, a more accurate type of biopsy can be offered. This biopsy is called a transperineal MRI-ultrasound fusion biopsy. In this test, the needle is inserted through the perineum rather than the rectum.