Diagnoses/ Screening

Cystoscopy :: Digital Rectal Examn ::  Pathology
PSA :: Radiology :: Urodynamics :: TRUS

:: TRANSRECTAL ULTRASOUND (TRUS) GUIDED PROSTATE BIOPSIES- Diagnostic Procedure

Introduction

The most common reason this test is performed is because either a blood test called PSA is abnormally high or the findings on examining the prostate through the back passage are abnormal. Sometimes though the prostate may feel normal and the PSA test is within the “normal” range but the PSA has started to rise quickly.

Ultrasound scans use sound waves to build up a picture of the inside of the body. To scan the prostate gland a small probe is passed into the back passage and the image of the prostate appears on a screen. This type of scan is used to measure the size and density of the prostate. A sample of cells (biopsy) can be taken at the same time for examination under the microscope by a pathologist.

Preparation for the test

You will have been provided with a prescription for a course of antibiotics. The first tablet should be taken on the night before the test and then on the morning of the test. The remaining tablets should be taken as directed until completion of the course. Although not critical, but more your own comfort, you should try to open your bowels prior to the procedure. You willbe given a light anaesthetic for the procedure so you will need to fast (nothing to eat or drink) for 6 hours before the test. So if the test is in the morning you should have nothing by mouth from midnight the night before. It is OK to have the antibiotic tablet and your other tablets in the morning with a sip of water. If your test is in the afternoon then you can have a light breakfast at around 6 AM and then nothing ater that. Please let Dr Gianduzzo and the staff know if you are on blood thinners such as plavix, wwarfarin, coumadin etc as you may need to sop these before the test. You will be advised of this at your appointment when the test is scheduled.

What actually happens?

A probe like instrument about 2.5 cm in diameter is gently inserted into the back passage. This is an ultrasound probe that allows visualisation of the prostate beyond what can be felt by the finger alone. More importantly, it allows for the placement of a special biopsy needle that collects samples of your prostate. You will have a light anaesthetic for the pocedure. A number of specimens (usually around 18 or so) are collected. The procedure takes about 20 minutes. You will need someone to drive you home as you will have been given a light anaesthetic.

What risks are associated with the procedure?

Following a prostate biopsy you can expect to see some blood in the urine, bowel motions and in the semen. Any blood in the urine or bowel motions usually settles by a week although brownish discoloration of the semen can last for up to a couple of months. Uncommonly, you may develop an infection but this risk is minimised by the antibiotics administered. If you develop fevers and begin to shake, which is rare, you should go to the nearest Emergency Department to be assessed. Infections can be very serious after a biopsy so it is important that you seek medical attention if you have symptoms of infvection even if it is in the middle of the night! Other risks such as bleeding and not being able to urinate after the procedure etc. will be discussed with you prior to your procedure.

Obtaining results

It generally takes up to a week to obtain the results of your biopsy. A copy of the result goes automatically to your urologist. It is critically important that you have a follow up appointment to follow up on the results of the pathology. Generally you will be contacted by phone with the results. If there is cancer present then we will send you some information bout prostate cancer to read and some forms for a bone scan and a CT scan. You will then be seen in around 2 weeks for the results of those scans and to discuss your management options for the cancer. If the test is negative, you will be sent a form for another PSA test and you will need another appointment in arund 3 months with a repeat PSA test. We may also ask that you come in earlier if there are other issues that we need to discuss with you or that need to be checked. If you have not been called with your results within 1 week of our biopsy please contact the rooms.