The prostate biopsy

Prostate biopsy is a medical procedure used to diagnose prostate cancer. Through prostate biopsy, a small sample of tissue is taken from the prostate to be examined under the microscope. This process is crucial for diagnosing any abnormalities in the prostate, including cancer. A prostate biopsy can be performed transrectally (through the rectum) or transperineally (by pricking the skin of the perineum). Transrectal prostate biopsy is the most common method of obtaining prostate biopsy samples.

When we need a prostate biopsy

A prostate biopsy may be recommended in several cases, including:

Elevated prostate-specific antigen (PSA) levels: If PSA levels in the blood are elevated, a biopsy may be needed to rule out or confirm the presence of prostate cancer;
Abnormalities detected during the digital rectal exam (DRE): If your doctor detects abnormalities in your prostate during the rectal exam, a biopsy may be indicated.

Preparing for a prostate biopsy

Medical consultation: Before the biopsy, it is essential to discuss with your doctor the risks, benefits, and alternatives to the procedure;
Discontinuation of anticoagulant medications: If you are taking anticoagulant drugs, your doctor may recommend that you temporarily stop them to reduce the risk of bleeding during the biopsy;
Intestinal cleansing: Proper intestinal cleansing reduces the risk of infection.

Prostate Biopsy Procedure

Location: The biopsy can be performed in the outpatient clinic or the operating room. The patient usually sits on his left side with his knees bent towards his chest;
Anesthesia: Local anesthesia is usually given to numb the area before the biopsy needle is inserted;
Ultrasound guidance: Often, an ultrasound scanner is used to guide the needle to suspicious areas of the prostate;
Sample collection: through the ultrasound, a needle is inserted through the wall of the rectum to take small tissue samples from the prostate;
Number of samples: 10 to 12 tissue samples are usually taken from different areas of the prostate to increase the accuracy of diagnosis;
Control and monitoring: After taking the samples, an ultrasound scan may be performed to check for complications.

After prostate biopsy

Recovery: After the procedure, it is expected to experience mild rectal and urine bleeding or pain for a few days;
Results: Tissue samples are sent to the laboratory to be examined under a microscope. Results are usually available within a week or two;
Discussion of results: Once the results are available, the doctor will discuss them with the patient and, if necessary, plan the appropriate treatment.

Possible complications

Bleeding: rectal and urinary bleeding may occur after the biopsy;
Infection: although rare, there is a risk of developing an infection after the biopsy;
Pain: Some patients may experience pain or discomfort in the prostate area or rectum after the procedure.

Risks of not performing a prostate biopsy

Not performing a prostate biopsy when indicated can carry some significant risks, especially if there are suspicions of prostate cancer. Here are some of the risks associated with not having a prostate biopsy done:

Failure to detect prostate cancer early: Prostate cancer is one of the leading causes of death in men. Without a prostate biopsy, cancer may not be diagnosed in the early stages, when it is more easily treated. Delaying diagnosis can lead to disease progression and worsening prognosis;
Missed opportunity for timely treatment: If prostate cancer is diagnosed in the early stages, there are more effective and less invasive treatment options available. Delaying diagnosis through a biopsy can limit treatment options and necessitate more aggressive or invasive therapies later on;
Anxiety and emotional stress: The presence of suspicious prostate symptoms can cause significant anxiety and emotional distress in patients. Without a diagnosis through a prostate biopsy, this stress can persist and negatively affect the patient's quality of life.

Conclusions

Prostate biopsy is an essential diagnostic tool for early identification of prostate cancer and other prostate conditions. While it may involve some temporary risks and discomforts, it is crucial for the effective management of prostate health.

However, the indication for performing a prostate biopsy must be carefully evaluated through a careful balance between risks and benefits that must always be personalized and adapted to the clinical case of each patient.

Not performing a prostate biopsy when indicated can pose significant risks to the patient's health, including failure to detect prostate cancer early and severe other prostate conditions. It is essential to consult a doctor and follow diagnostic recommendations to ensure an accurate evaluation and prompt treatment if necessary.