Prostate Biopsy Risks

Prostate biopsy is a simple diagnostic procedure that involves collection of tissue samples from the prostate gland to rule out any malignant lesion or serious pathology. Prostate gland is walnut shaped male gland that is responsible for the production of a fluid (also known as prostatic fluid) that plays a major role in the transportation and nourishment of sperms.

During prostate biopsy (also referred to as core needle biopsy) healthcare professionals collects few tissue samples from different parts of the gland, with the help of a fine needle. Urologist, who particularly specializes in men’s sex organs and urinary system usually perform prostate biopsies under ultrasound guidance to minimize the risk of complications.

According to latest estimates, more than 1 million prostate biopsies are performed in the United States each year (1).

When Is Prostate Biopsy Needed?

The urologist recommends prostate biopsy when the previous test results of digital rectal exam or prostate specific antigen blood test are abnormal or indicative of prostate cancer. You’re likely to be recommended the test under following circumstances:

• If your serum prostate specific antigen levels (PSA) are significantly higher than the normal range for your respective age.
• If your doctor came across any lump or other related abnormalities while performing a digital rectal exam.
• If your previous biopsy was normal however your prostate surface antigen levels are still high.
• If your previous biopsy test result confirmed the cells to be abnormal but not cancerous.

As part of the biopsy, the samples obtained from the procedure are examined carefully under the microscope to look for abnormal cells that are suggestive of prostate cancer. If the samples do exhibit abnormalities in the morphology, configuration and other characteristics, then further evaluation is performed to ascertain cancer prognosis (as to how much time would it take on a rough scale for cancer cells to spread and grow). Then the best treatment options are considered according to the patient’s condition.

Prostate Biopsy Risks

Following are some common risks associated with prostate biopsy:

• Infection: Occurrence of the infection is by far the most common adverse effect of the prostate biopsy procedure. It’s been noted that men who get prostate biopsy often develops a post-procedure urinary tract infection. However it can easily be treated with the right medications such as antibiotics; based on the causative agent and nature and type of the infection.
• Bleeding at the site of biopsy: Most men experience rectal bleeding after getting a prostate biopsy. Make sure to tell your doctor if you are taking any medications that may aggravate the risk (such as blood thinners). Do not start any medication or anticoagulant without speaking to your doctor.
• Presence of blood in the semen: Semen often becomes rust-colored or reddish in color after prostate biopsy. This highlights the presence of blood in the semen and it’s usually not something to be concerned about. The reddish tint disappear/ resolves spontaneously within a few weeks without requiring any treatment.
• Difficulty in urination: Some men experience difficulty in urinating after prostate biopsy. In rare cases, a temporary urinary catheter may also be needed. According to a study reported in Clinical Urology journal (2), persistent hematuria (lasting 3 to 7 days) is also reported in more than 47% patients.

According to a new study reported in the Journal of Urology (3), investigators suggested that the 30-day hospitalization rate within a 30-day period of prostate biopsy is 6.9%; however, no serious or permanent damage is usually reported.

Preparing For The Prostate Biopsy

In order to prepare for the biopsy, the urologist is likely to ask you to do the following:

• Avoid taking medications that can put you at risk of bleeding, for example warfarin, aspirin, ibuprofen and some herbal supplements for a few days prior to the prostate biopsy.
• Perform a cleansing enema at home prior to the procedure appointment.
• Take specific antibiotics 30-60 minutes prior to the procedure as a precaution to avoid the occurrence of any infection.

Like any invasive diagnostic procedure, prostate biopsy is also associated with some risks; but since early detection of prostate cancer can greatly improve the prognosis, it is highly recommended to opt for biopsy.

References

1. Thompson, I. M., Ankerst, D. P., Chi, C., Goodman, P. J., Tangen, C. M., Lucia, M. S., ... & Coltman, C. A. (2006). Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. Journal of the National Cancer Institute, 98(8), 529-534.

2. RODRIGUEZ, L. V., & TERRIS, M. K. (1998). Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. The Journal of urology, 160(6), 2115-2120.

3. Loeb, S., Carter, H. B., Berndt, S. I., Ricker, W., & Schaeffer, E. M. (2011). Complications after prostate biopsy: data from SEER-Medicare. The Journal of urology, 186(5), 1830-1834.