The prostate biopsy is requested by the urologist if there are changes in the prostate exam or PSA levels, the protein produced by the gland. Fragments of the prostate are collected and analyzed by a pathologist to confirm or exclude a cancer diagnosis. Learn more!
The prostate biopsy is a procedure that may raise questions or concerns, but its role is crucial for male health. When exams like PSA or the digital rectal exam indicate changes, it becomes the definitive step to clarify the diagnosis.
Next, understand how the procedure works, when it is indicated, and why it is essential for the early detection of serious conditions like prostate cancer.
What Is a Prostate Biopsy and What Is It For?
A prostate biopsy is a procedure performed by a urologist or radiologist that collects tissue fragments from the prostate gland using a fine needle.
There are two ways to perform the procedure. In the first, the needle is inserted into the rectum. In the second, it is inserted into the perineum, the area between the scrotum and anus.
The purpose of the prostate biopsy is the same regardless of the method: to determine whether or not there are cancer cells in the body.
There are two types of prostate biopsy. See below:
- Needle prostate biopsy: The needle is inserted directly into the prostate through the rectum. This method is less invasive but carries a slight risk of infection due to proximity to the rectum;
- Transrectal biopsy: Also called transperineal biopsy, the needle is inserted through the skin between the scrotum and anus, avoiding contact with the rectum. There is some discomfort, but the risk of infection is lower.
When Is a Prostate Biopsy Indicated?
The urologist requests a prostate biopsy when there are abnormalities in the digital rectal exam and PSA levels (Prostate-Specific Antigen), a protein that facilitates sperm movement.
Abnormalities include:
- Prostate exam: Nodules and hardened areas detected during the exam;
- PSA test: When the PSA level is between 4 ng/mL and 10 ng/mL, indicating a 25% risk of cancer.
There is also the saturation biopsy, indicated for men who, despite abnormalities in the digital rectal exam and PSA, had a negative result in the traditional biopsy.
Preparation for the Biopsy
Preparing for the biopsy is simple. The patient must take the prescribed antibiotic one day before and continue using it for 5 to 7 days after the procedure. In addition:
- Stop taking anticoagulant medications;
- Fast for 8 hours;
- Urinate before the exam;
- Clean the rectum 2 hours before (only for the transrectal biopsy).
How Is the Procedure Performed?
The prostate biopsy is performed under light sedation or local anesthesia. Men with health issues are evaluated by a cardiologist, and the procedure is carried out in a hospital.
The ultrasound device used is pen-shaped, with a space for the needle. This needle is used by the urologist or radiologist to collect 12 to 14 samples.
How Long Does a Prostate Biopsy Take?
Many people wonder how long a prostate biopsy takes. Although invasive, the procedure lasts about 10 minutes.
Post-Biopsy Care
Although no rest time is required after the prostate biopsy, there are post-exam guidelines to follow:
- Do not drive or operate machinery immediately after the procedure;
- Eat light meals;
- Avoid climbing stairs for 2 days after the exam;
- Avoid heavy lifting for 3 days;
- Avoid physical activities for 3 to 5 days;
- Abstain from sexual activity for the time recommended by the doctor;
- Continue taking antibiotics as instructed by the specialist.
Are There Any Exams That Replace a Prostate Biopsy?
A prostate biopsy is an essential exam for clarifying diagnoses, but other exams can complement the medical evaluation. Procedures like multiparametric MRI, for example, provide detailed prostate analysis and guide biopsies to affected areas.
Risks and Complications of Prostate Biopsy
The procedure is performed with sedation or local anesthesia, minimizing potential discomfort. However, there are some associated risks and complications. The most common is a slight bleeding in urine, stool, or semen, which resolves within 2 days.
Severe symptoms such as urinary obstruction, infection, and bleeding are rare. According to this article by the A.C. Camargo Cancer Center team in São Paulo, 1.6% of men with these symptoms require hospitalization.
What Happens If the Biopsy Result Is Positive?
If the biopsy result is positive, the urologist may request multiparametric MRI, bone scintigraphy, or PET Scan. These exams help define the stage of the cancer and determine the most appropriate treatment.
Urological Follow-Up Is Crucial for Male Health
Annual check-ups with a urologist are important for the early detection of conditions, enabling more effective treatment.
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