Understanding the Prostate
The prostate is a small gland that forms part of the male urinary and reproductive system. Situated just below the bladder and surrounding the urethra, it produces fluid that supports and protects sperm.
As men age, it is common for the prostate to enlarge. This benign enlargement, known as Benign Prostatic Hyperplasia (BPH), can cause urinary symptoms such as:
- Frequent urination
- A weak or slow urine stream
- Difficulty emptying the bladder
- Increased urgency, especially at night
While these symptoms are often caused by benign enlargement, they can sometimes indicate other conditions, including prostate cancer.
Why Might I Need a Prostate Biopsy?
A prostate biopsy is performed to determine whether prostate cancer is present.
Your urologist may recommend a biopsy if you have:
- An elevated PSA (Prostate-Specific Antigen) blood test
- An abnormal digital rectal examination (DRE)
- A suspicious lesion identified on prostate MRI
- Other clinical findings that require further investigation
It is important to understand that an elevated PSA or abnormal examination does not necessarily mean you have prostate cancer. A biopsy is the only way to confirm or exclude the diagnosis.
How is a Prostate Biopsy Performed?
Most prostate biopsies are performed using ultrasound guidance, allowing your urologist to accurately target the prostate.
Depending on your individual circumstances, the biopsy may be performed:
- Through the perineum (the skin between the scrotum and anus), known as a transperineal biopsy
- Through the rectum, known as a transrectal biopsy
Multiple small tissue samples (called cores) are collected from different areas of the prostate and sent to a specialised laboratory for microscopic examination.
The procedure is performed under either local anaesthetic or general anaesthetic, depending on your individual treatment plan.
What to Expect During the Procedure
To reduce the risk of infection, antibiotics are usually given before the biopsy and, in some cases, afterwards.
Please inform your urologist about any allergies, blood-thinning medication, or other medical conditions before your procedure.
Local Anaesthetic
If performed under local anaesthetic:
- The area will be numbed using a local anaesthetic.
- Ultrasound guidance is used throughout the procedure.
- Several tissue samples (typically 12 or more) are collected.
- Most patients experience mild pressure or temporary discomfort rather than significant pain.
General Anaesthetic
If your biopsy is performed under general anaesthetic:
- You will be asleep throughout the procedure.
- Do not eat or drink for at least 8 hours beforehand unless instructed otherwise.
- Depending on your procedure, you may return home the same day or require an overnight hospital stay.
Recovery After a Prostate Biopsy
Most patients recover well and are able to resume light daily activities within a day or two.
Mild Bleeding
It is normal to notice:
- Blood in the urine
- Blood in the stool
- Blood in the semen
These symptoms can persist for several days and, particularly in the semen, may last for several weeks before gradually resolving.
If you experience heavy or persistent bleeding, please contact your urologist.
Mild Discomfort
Some tenderness or discomfort around the rectum or perineum is common after the procedure and usually improves within a few days.
Simple pain relief is generally sufficient.
Infection
Although uncommon, infection is the most important complication following a prostate biopsy.
Seek urgent medical attention if you develop:
- Fever
- Chills or shaking (rigors)
- Increasing pain
- Feeling generally unwell
- Difficulty passing urine
These symptoms may indicate a serious infection requiring prompt treatment with intravenous antibiotics.
Difficulty Passing Urine
Temporary swelling of the prostate following the biopsy can occasionally make it difficult to urinate.
If you are unable to pass urine or your symptoms worsen, contact your urologist immediately, as further treatment may be required.
Understanding Your Results
Your biopsy samples are examined by a specialist pathologist, with results typically available within several days.
If prostate cancer is identified, your urologist will discuss the findings with you in detail and explain all appropriate treatment options.
Your personalised treatment plan will consider several factors, including:
- The biopsy (histology) results
- PSA level
- MRI findings and clinical examination
- The stage and grade of the cancer
- Your age and overall health
- Your personal treatment goals and preferences
Many prostate cancers are slow-growing and highly treatable, particularly when detected early. Your urologist will guide you through every step of the decision-making process to ensure you receive the most appropriate care.
