A prostate biopsy may be performed if abnormality is found by the doctor or nurse, while performing a digital rectum examination (DRE). A trans-rectal ultrasound scan (TRUSS) of the prostate gland may be requested to assess any abnormality felt on DRE, or if a blood test shows an elevated PSA (prostate specific antigen) blood test.
The procedure takes place in hospital and is performed without anesthetic.
The radiologist or urologist performing the procedure will have requested any patients taking blood thinning agents, e.g. aspirin or warfarin, to have discontinued them for up to one week beforehand because of the risk of bleeding. Antibiotics will be given to the patient beforehand to cover the risk of infection.
Throughout the biopsy, the patient lies on his side with his knees bent and his legs pulled up to his chest.
If any abnormality is seen on the ultrasound scan, a biopsy is taken there and then. The patient feels a number of short, sharp pains as a number of small needles move in and out of the prostate.
As many as 16 small cylindrical samples can be taken, four from each quadrant of the gland.
The procedure can also be done without ultrasound guidance. To do this the doctor uses a finger to guide a single needle to the abnormal area and takes a series of biopsies, one after the other.
After the procedure: the patient may experience some discomfort for a short period of time and possibly notice some blood in their urine intermittently for a few days.