Trans-rectal Ultrasound of the Prostate with Needle Biopsy
TRANS-RECTAL ULTRASOUND uses high-frequency sound waves to look at the prostate. With the patient lying on his side on the examination table, a slender probe is inserted into the rectum. As the probe scans the prostate an image of the prostate appears on a screen. Your doctor, along with a specially trained technician, will search for any abnormal areas. In this way, cancer of the prostate may be detected. Also, the size of the prostate can be measured and other abnormalities, such as stones or infection, may be seen.
Ultrasound is one of the most sensitive ways to image the prostate. However, ultrasound cannot by itself make a diagnosis of cancer, so a biopsy is necessary if cancer is suspected.
In order to get a clear image of the prostate, it will be necessary to take a Fleet enema two hours before the test. If there is a possibility of biopsy, other precautions will be needed as described below.
The ultrasound exam lasts approximately 15 minutes. It is not painful, but there may be some discomfort. The sensation will be similar to your doctor's regular rectal exam as the probe is about the same width as a finger.
PROSTATE NEEDLE BIOPSY will be recommended if prostate cancer is suspected. A local anesthetic will be injected to reduce any possibility of pain during the biopsy. A very thin, hollow needle will be passed through a channel in the ultrasound probe. The needle will remove a tiny sliver of tissue which will be sent to a pathologist who will study it under a microscope to check for cancer cells.
Each biopsy only lasts a split second. Your doctor will personally perform the tests and will explain all events as they occur. There will be little or no pain afterwards.
Needle biopsy of the prostate is relatively safe but there is some risk of bleeding or infection. For this reason antibiotic tablets will be given before and after the biopsy and an intramuscular injection of antibiotic may be administered immediately prior. No aspirin products should be taken for 10 days before the procedure and any other blood thinners such as coumadin or arthritis and pain medications should also be stopped. Notify your doctor if you bleed easily or have a known bleeding disorder.
AFTER THE BIOPSY, rest at home is advised until the following day. Some blood in the urine or in the stool is common for 1 or 2 days. Small amounts of blood in the semen is normal and may persist for a few weeks after biopsy. Notify your doctor immediately if excessive bleeding occurs or if you develop a fever over 100.5°. Drink plenty of fluids for the first 24 hours.
The following day you may gradually resume usual activities. Your doctor will want to see you one or two weeks after the test to check the urine and to discuss biopsy results and any further plans. Although trans-rectal ultrasound with biopsy may be the most accurate way available today to detect prostate cancer, it is not guaranteed. Even if the biopsy result is normal, further follow-up examinations may be recommended.