A prostate biopsy is a medical examination that consists of removing samples of prostate tissue using a biopsy needle that is introduced, under ultrasound control, through the wall of the rectum (transrectal biopsy) or the perineal skin (transperineal biopsy). The tissue is subsequently analysed in the laboratory. This examination is carried out to diagnose or exclude a prostate cancer when there are suspicions of the disease, notably if:
- The PSA level (prostate-specific antigen) in the blood is high
- A digital rectal examination shows an anomaly.
- Imaging (MRI) shows a suspect zone
Before the examination
- Stop taking anticoagulants or antiplatelets before the examination but after discussing this with your doctor.
- Undertake a rectal lavage (Cleen Enema, available from a chemist without a prescription) at home 1 to 3 hours before the examination.
- Take a tranquillizer (Xanax 0.25mg) as prescribed by your doctor.
During the examination
- Lie on your back with your legs elevated in stirrups; a local anaesthetic is administered to reduce discomfort during the examination.
- An ultrasound imaging probe is introduced into the rectum to guide the biopsy needles.
- Several samples are taken, in the suspect zone identified by the MRI and in the rest of the prostate (8 to 15 samples on average)
Duration
- 15 to 30 minutes
After the examination.
- A rest area is available where you can rest for a while after the examination if necessary.
- It is preferable to be accompanied on the journey home.
- Blood in the sperm (frequent), the urine (rare) and the faeces (extremely rare) is possible and ceases of its own accord within a few days or weeks.
- Go to the hospital emergencies if you have a fever (>38 °C), are unable to urinate or bleed too profusely.
- The results will be discussed with your urologist at your scheduled consultation which will make it possible to decide if other examinations are needed.
A biopsy of millimetre precision
Prostate biopsies play a central role in the treatment of prostate cancer. The main aim is not only to confirm the presence of cancer but also to assess how aggressive it is by determining its grade (defined by the Gleason score or ISUP grade). This evaluation is crucial as it guides subsequent treatment choices.
There are a number of techniques for performing these biopsies. At the Willy Grégoir Prostate Cancer Centre we have been engaged for a number of years in developing and perfecting techniques for MRI-3D ultrasound image fusion in cooperation with the company KOELIS, world leader in the field. This method combines the precision of MRI images, which localise the suspect zones, and a 3D ultrasound carried out in real time. This makes it possible to create a 3D mapping of the prostate and to guide the needles with millimetre precision.
This technology has also opened up the path to the development of ultra-focal prostate therapy by using 3D mapping. These innovative treatments make it possible to destroy the cancer while conserving the healthy tissue and thereby limiting side effects.