All About Prostate Biopsy

A prostate biopsy is an examination done when the PSA value in the blood test is high or when changes in its size or shape are found during digital rectal examination, being definitive to detect or confirm a diagnosis of prostate cancer.

Prostate biopsy does not hurt, but it can be uncomfortable and, for this reason, is usually done under local anesthesia or mild sedation. However, after the examination, it is possible that the man will feel some burning in the region, but it will pass in a few hours.

When to do a prostate biopsy

This test is indicated when the prostate gland appears hard or enlarged and when the PSA result is:

  • PSA above 4 ng / mL at any age:
  • PSA above 2.5 ng / mL in patients up to 55 years old;
  • PSA density above 0.15 ng / mL;
  • PSA speed above 0.75 ng / mL / year.

The test should be repeated when the doctor is not satisfied with the result of the 1st biopsy, especially if there is: 

  • Persistently elevated or elevated PSA with a speed> 0.75 ng / mL / year;
  • High-grade prostatic intra-epithelial neoplasia (PIN);
  • Atypical proliferation of small acini (ASAP). 

Watch the following video and learn about other tests that the doctor can perform:

How prostate biopsy is done

The biopsy is done with the man lying on his side, with his legs bent, properly sedated. Then the doctor makes a brief evaluation of the prostate by performing the digital rectal examination, and after this initial evaluation, the doctor introduces an ultrasound device in the patient’s anus, which guides a needle to the prostate.

This needle pierces the intestine and collects several pieces of tissue from the gland, and from the regions around it, which will be analyzed in the laboratory, looking for cells that may indicate the presence of cancer.

What is the price of prostate biopsy

The price of prostate biopsy varies between 200 to 500 reais, according to the location selected. When cancer is suspected, this exam can be done free of charge by SUS, but it can take a long time to make an appointment.

How to prepare for biopsy

Biopsy preparation is important to avoid complications and usually includes:

  • Take the antibiotic prescribed by the doctor, for about 3 days before the exam;
  • Do a full fast of at least 6 hours;
  • Clean the intestine before the exam;
  • Urinate a few minutes before the procedure;
  • Bring a companion to help you return home.

After a prostate biopsy, the man must also take the prescribed antibiotics, eat a light diet in the first hours, avoid physical exertion in the first 2 days and maintain sexual abstinence for 3 weeks.

Understanding the biopsy result

The results of the prostate biopsy can be:

  • Positive: indicates the presence of cancer developing in the gland;
  • Negative: the cells collected did not change.

When the prostate biopsy result is negative, the doctor may ask to repeat the test to certify the results, when he suspects that the result is not correct. This new exam should be performed in 3-4 weeks. 

What are the possible risks of biopsy

Since it is necessary to pierce the intestine and remove small pieces of the prostate, there is a risk of some complications such as:

1. Pain or discomfort

After the biopsy, some men may experience mild pain or discomfort in the anus region, due to scarring of the intestine and prostate. If this happens, the doctor may advise the use of some mild pain relievers, such as Paracetamol, for example. Usually, the discomfort disappears within 1 week after the exam.

2. Bleeding

The presence of a small bleed in the underwear or in the toilet paper is completely normal during the first 2 weeks, even in the semen. However, if the amount of blood is too high or disappears after 2 weeks, it is advisable to go to the doctor to see if there is any bleeding.

3. Infection

Since the biopsy causes a wound in the intestine and prostate, there is an increased risk of infection, especially due to the presence of various types of bacteria in the intestine. For this reason, after the biopsy the doctor usually indicates the use of an antibiotic.

However, there are cases in which the antibiotic is not enough to prevent infection and, therefore, if you have symptoms such as fever above 38ÂșC, severe pain or strong smelling urine, it is advisable to go to the hospital to identify if there is an infection and initiate proper treatment.

4. Urinary retention

Although it is more rare, some men may experience urinary retention after the biopsy due to inflammation of the prostate, caused by the removal of pieces of tissue. In these cases, the prostate ends up compressing the urethra, making it difficult for urine to pass.

If this happens, you should go to the hospital to remove the accumulation of urine from the bladder, which is usually done with the placement of a bladder tube. Understand better what a bladder catheter is .

5. Erectile dysfunction

This is the rarest complication of the biopsy, but it usually disappears within 2 months after the exam. In most cases, the biopsy does not interfere with the ability to have intimate contact.

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