The prostate is part of the male reproductive system It is a walnut-sized gland that produces fluid for semen. The prostate is found below the bladder and surrounds the upper urethra .

What Is a Needle Biopsy?

Needle biopsy is a relatively painless procedure that is done in the doctor's office or in a clinic. A long, thin needle is inserted into the prostate to collect a small amount of tissue and fluid. These samples are then examined by a doctor for infection and abnormal cells.

Why Do I Need A Needle Biopsy

During middle age, the prostate gradually increases in size. This enlargement may not cause any symptoms, or it may interfere with urination. Symptoms of an enlarged prostate include:

• Increased frequency of urination
• Decreased force of urine stream
• Trouble with urination
• Awakening at night to urinate

Another reason for having a needle biopsy is an increase in prostate-specific antigen (PSA) in your blood. PSA is a substance made by both normal and cancerous prostate cells. A needle biopsy may be necessary to discover the cause of increased PSA.

In addition to the PSA test and needle biopsy, a digital rectal exam (DRE) is sometimes performed. In the DRE, your doctor places a gloved finger in the rectum to feel the prostate gland for any abnormalities. An ultrasound (an image created by sound waves) may also be needed. Ultrasound testing involves placing a small probe in the rectum to view the prostate gland. This test may be done in the doctor's office or the x-ray department of a hospital.

Preparation for Needle Biopsy

1. It is important to reduce the risk of infection by internal cleaning of the rectum. Therefore, several hours prior to you biopsy, you should have a rectal enema. Ask your nurse or doctor how to administer and where to purchase the enema.
2. Do not eat anything after using the enema. You may drink clear fluids unless you are told otherwise by your doctor. If you have diabetes, ask your doctor how you should change your diet.
3. To further reduce chances of infection, some patients may need to take antibiotics before their needle biopsies. Your doctor will inform you if you need to do this.
4. Taking aspirin, ibuprofen, or other blood thinners may cause unnecessary bleeding after biopsy. Ask your doctor which medicines you should avoid and for how long.

Biopsy With Ultrasound

Most needle biopsies are done with the aid of ultrasound. After the ultrasound probe is placed in the rectum, an image of the prostate gland can be seen. If an abnormality (lesion) is identified, the needle is placed into that area to obtain a piece of tissue. Often, a number (six or more) of biopsies are done. This is because many prostate cancers cannot be seen on ultrasound. Also, performing more than one biopsy can help find the cause and extent of the abnormality (Figure 2).

Biopsy Without Ultrasound

Some needle biopsies are performed without ultrasound. In this case, instead of the ultrasound probe, a finger is placed into the rectum to examine the area of the lesion. The biopsy needle is then guided to this area and a piece of tissue is collected. What to Expect After Needle Biopsy

1. After the procedure, your doctor may prescribe an antibiotic. If you do not receive a prescription prior to leaving the office of clinic, be sure to ask your recovery nurse about this. Avoid using aspirin for several day to avoid bleeding.
2. It is normal after the biopsy to have blood in your urine far 3 or 4 days and possibly light rectal bleeding. To clean out your urinary tract, drink four to six 8-ounce glasses of water daily for 3 or 4 days. If you are passing large blood clots, call your doctor.
3. It is normal to experience burning on urination for 24 hours after the biopsy. If you are having trouble urinating, try to urinate into warm baths. This may lessen your discomfort.
4. After the procedure, some men complain of a clear to brownish discharge from the penis. You may notice blood in your semen for up to 1month afterward. If this happens, be sure to tell your doctor.
5. If you have nausea, vomiting, shaking chills, a fever greater than 100?F or burning on urination after 24 hours following the biopsy, call your doctor immediately (day or night).
6. You should not do any heavy lifting for 24 hours. Do not strain yourself during a bowel movement for the next several days.
7. Sexual activity should be avoided for 24-48 hours.
8. Be sure to make a follow-up appointment with your doctor.

• Your temperature rises above 100°F
• You have nausea, vomiting, or shaking shills
• You are experiencing burning while urinating or are passing blood clots
• You are unable to urinate when you feel that you bladder is full
• You have a reaction to your medicine such as a rash, nausea, or vomiting

Who is a urologist?

A urologist is a doctor who specializes in the diagnosis and treatment of urinary tract conditions, including diseases of the prostate.

Does every patient with a prostate abnormality need a needle biopsy?

The need for a needle biopsy depends on several factors, including your PSA level and age. Be sure to discuss this issue with your doctor.

Can antibiotics prevent infection?

Antibiotics are a class of drugs used to stop the growth of or kill bacteria that cause infection. They may be used before a medical procedure to prevent an infection from occurring. Please talk with your doctor before starting a course of antibiotic therapy.

What are the treatment options for prostate cancer?

There are various options for the treatment of prostate cancer. These include measures ranging from surgery to close observation. Your doctor will further discuss these options with you.

Important Terms

Biopsy

a procedure in which a piece of tissue is removed for diagnostic examination.

Nodule

a bump or growth in the prostate often described as a hard or firm area.

Prostate-specific antigen (PSA)

a substance produced by the prostate. PSA levels are measured by a simple blood test and are used to help find or follow prostate cancer.

Ultrasound

a diagnostic technique using high frequency sound waves to visualize an organ, such as the prostate.

Urethra

the urine channel leading from the bladder, through the prostate and penis.

To continue reading about the following urological topics,
please click on the underlined words.

General Urology

• Hematuria
• Hematuria-2
• Testicular Self-Examination