The most common reason this test is performed is because either a blood test called PSA is abnormally high or the findings on examining the prostate through the back passage are abnormal.
Ultrasound scans use sound waves to build up a picture of the inside of the body. To scan the prostate gland a small probe is passed into the back passage and the image of the prostate appears on a screen. This type of scan is used to measure the size and density of the prostate. A sample of cells (biopsy) can be taken at the same time for examination under the microscope by a pathologist. The scan may be uncomfortable but it only takes a few minutes.
Preparation for the test
You will have been provided with a prescription for a course of antibiotics. The first tablet should be taken on the morning of the test. The remaining tablets should be taken as directed until completion of the course. Although not critical, but more for your own comfort, you should try to open your bowels prior to the procedure. There is no need to fast for the test (that is, you may eat and drink as desired right up until the time of the test).
What actually happens?
A probe like instrument about 2.5 cm in diameter is gently inserted into the back passage. This is in fact an ultrasound probe that allows visualisation of the prostate beyond what can be felt by the finger alone. More importantly, it allows for the placement of a special biopsy needle that collects samples of your prostate. At the time of biopsy you will hear a loud clicking noise that may startle you momentarily. You will feel a slight sting as the needle passes but it literally happens in a split second. A total of 6 biopsy specimens are usually collected. The procedure takes about 20 minutes and you are able to drive home if you desire but it is often a good idea to have somebody with you due to the natural anxiety you may have over the anticipation of the results.
What risks are associated with the procedure?
Following a prostate biopsy you can expect to see some blood in the urine, bowel motions and in the semen. Any blood in the urine or bowel motions usually settles by a week although brownish discoloration of the semen can last for up to a month. Uncommonly, you may develop an infection but this risk is minimised by the antibiotics administered. If you develop fever and begin to shake, which is rare, you should go to the nearest Emergency Department to be assessed.
It generally takes up to a week to obtain the results of your biopsy. A copy of the result goes automatically to both your urologist and your referring family doctor. It is critically important that you have a follow up appointment within 7 days of the procedure to follow up on the results of the pathology.