Prostate biopsy is considered to be a highly informative diagnostic technique that helps to detect such malignant pathologies as cancer of the gland in a timely manner. The procedure involves obtaining a sample of prostatic tissue for its further cytological and histological examination.
Indications and contraindications
Biopsy is divided into primary and secondary.
Indications for a primary biopsy of a primary nature are suspected of a malignant tumor:
- If preliminary analyzes showed an increased level of a specific prostatic antigen - more than 4 ng / ml;
- If the ultrasound transabdominal or transrectal examination showed a low level of echogenicity in the prostate;
- If fingerprinting in the prostate has revealed a specific seal or knot.
If the primary prostatic biopsy has shown negative results, and the patient has some deviations, a secondary procedure is performed. In particular, it is indicated if:
- The level of the specific antigen continues to increase or remains at the same elevated level;
- With antigen density greater than 15%;
- If the proportion of free antigen in relation to the total antigen is less than 10%;
- If the primary diagnosis showed a high degree of neoplasia in the prostate tissue;
- If a biopsy was not obtained in the initial diagnosis.
Although taking a biopsy is a diagnostic procedure, it can be compared to a micro-operation, so it has its own contraindications:
- Recent abdominal perineal rectal intestinal tract;
- Strongly pronounced anal stricture;
- Acute form of inflammation of the prostate;
- The presence of hemorrhoids of complicated form;
- The presence of pathologies associated with blood flow disorders;
- Acute inflammation of the anal isthmus and rectal tissue.
Methods for taking biomaterial
Several methods for sampling a biopsy are currently used:
- Polyfocal - when the procedure is performed under ultrasound control. Samples of tissues are taken from 12 points of the prostate;
- Blind , with finger probing. The doctor enters the needle into the rectum and the finger controls its movement. The biopsy specimen is taken from 4-6 points of the gland;
- Saturation-based - when a biopsy specimen is taken under the control of an ultrasound machine, only the material is taken from 24 points on the organ. This method is considered the most advanced and modern, it allows you to detect prostate cancer at the initial stage of pathology.
In addition, transurethral, transrectal and transperineal biopsies are isolated.
Multifocal transrectal
A similar type of biopsy of the prostate can be performed in different poses: on the back with the emphasis of the legs on the supports, on the side with the knees pulled to the chest and in the knee-elbow position.
An anesthetic is injected into the area around the prostate gland. All actions are controlled by transrectal ultrasound, which is necessary to accurately hit the needle in the desired area of the gland.
Usually a biopsy specimen is taken by a special spring needle, which quickly enters the prostate and leaves it quickly.
In a similar way, up to 10 pieces of prostatic tissue are taken from different parts of the body. The procedure takes several minutes.
If the biopsy is performed transrectally, but without ultrasound, the finger is a finger of a specialist who feels the prostate when the needle is inserted through the rectum. In this case, the needle is rotated inside the prostate, a piece of biomaterial is captured, and then taken out.
This biopsy lasts much longer - up to half an hour.
Transurethral
Transurethral technique of prostatic biopsy is a procedure in which a patient is placed on his back, and his legs are placed on special pedestals. Transurethral diagnosis is performed using spinal, local or general anesthesia.
Transurethral prostate biopsy is performed using a special device - a cystoscope, and a cutting loop is used to take the biomaterial. The duration of obtaining a biopsy in this way is about 40-45 minutes.
Transperineal
The preparation of prostatic biosamples by the transperineal method is rarely used in urological practice. The patient is placed on his side or back, his knees are pinched.
The diagnostic procedure is performed using general or local anesthesia.
The essence of the procedure is that a small incision is made in the perineal area of the man, through which the needle is inserted to obtain a biopsy. The doctor fixes the finger with the finger to make the prostate easier to insert. Samples are taken from different parts of the prostate gland. The duration of such a procedure takes no more than half an hour.
Control methods
Most often the prostate biopsy procedure is performed under TRUS-control, i.e. under transrectal ultrasound control. The use of methods with finger probing blindly today is unprofitable and usually not applied.
Preliminary preparation of
Before carrying out a biopsy of the prostate the patient must be prepared for the procedure.
If they do occur, the patient is prescribed antibiotic therapy.
In preparation for a biopsy, the doctor must know about the medications taken by the patient, the presence of allergies to medications, etc. Immediately before the procedure, the patient is put an enema for bowel cleansing.
Along with anesthesia, the patient is sometimes relieved with sedatives.
How is prostate biopsy performed?
Prostate biopsy procedure is performed only in an outpatient setting, and some even under general anesthesia.
The patient must undress and put on a disposable gown, as before the operation, what is essentially the procedure for taking a prostate biopsy.
The procedure itself is performed by one of the above methods: transurethral, transrectal or transperineal.
It is worth noting that taking a biopsy specimen from the prostate gland for each man is considered the most unpleasant procedure. And it is more unpleasant from the psychological and moral point of view, rather than in terms of soreness.
For analgesia, the introduction of a 2% lidocaine gel into the rectal canal is most often used. This method of anesthesia is the most effective and safe for transrectal biopsy of the prostate.
Implications of prostate biopsy
Even a diagnostic procedure for biopsy of the prostate can have unpredictable consequences. For example:
- Allergic shock in response to an anesthetic drug;
- Straight intestinal bleeding lasting no more than 3 days;
- Urinary or urethral bleeding, resulting in the formation of bruising, increased or violated urination;
- Infectious lesions, most characteristic of patients with latent inflammation of the prostate gland.
The doctor should be contacted immediately if severe bleeding, severe pain and fever, or the patient can not empty the bladder for more than 3 days for 8 hours after the procedure.
Recommendations after analysis of
The day after the procedure is recommended to stay at home, and further adhere to such recommendations:
- Over the course of a month, it is recommended to avoid physical activities such as exercising on simulators, running or swimming;
- Refuse for this period from bathing procedures and visiting the sauna, because overheating of the disturbed prostate is of no use;
- Supercooling should also be avoided;
- During the week, observe the drinking regimen, consuming at least 2-2.5 liters of liquid per day;
- For a month it is recommended to adhere to a dietary diet, eliminating foods that irritate the urinary system, such as alcohol, spicy foods and caffeinated drinks;
- You can have sex in about a week and a half.
What can the results tell?
Usually, prostate biopsy results are ready for 10 days.
If abnormal cells are found in the prostate, then experts determine the extent of cancer incidence.
Revealed in 8-10 units indicate the presence of a high risk of aggressive pathology.
If a family has had cases of prostate cancer, then it is recommended that men undergo urological examination every year( starting at age 45).
The soreness of the
procedure When the doctor injects an anesthetic, an easy injection is felt, and when the biopsy needle is injected into the prostate, the patient experiences minor discomfort.
For a month after the diagnostic prostatic biopsy, sperm can change the shade. If the study was carried out transrectally, then in the rectal tissues, bleeding may begin.
If the biopsy specimen was taken under general anesthesia, then the patient is kept in the ward for some time after the procedure. And in the evening, already at home, a man can feel a noticeable fatigue.
Reviews of patients
Nikolay:
I do not argue at all that prostate biopsy is very informative, and often necessary procedure. But how unpleasant she, unfortunately, experienced on herself. We performed it transrectally. Pain, as such, I did not feel, although there was a specific discomfort. And more emotional experiences than something else. My analysis showed nothing dangerous. There were no consequences after the procedure. Unless in a perineum pulled 2-3 days and all.
Oleg:
The reason for the treatment were frequent hikes in the toilet and tenderness in the perineum. The doctor accepted me politely, listened, then said that I need to undergo a biopsy. He experienced a lot of terrible sensations, for which he laid out a round sum. I have not been diagnosed with prostatitis, but the blood from one place has been disturbing for a month.
How much does the analysis cost?
The average price of prostate biopsy in Moscow clinics is about 5500-16500 rubles. The final cost depends on the method of obtaining a biopsy, methods of control, type of anesthesia and a set of additional services.
Video interview with a patient after a biopsy of the prostate: