You have been scheduled for a prostatic biopsy under ultrasound guidance at the office of Adult & Pediatric Urology, P.C.

Prior to the procedure, you may need a blood study to help with the diagnosis of possible prostate cancer. Because of the possibility of excessive bleeding from the procedure, be sure to let us know if you have a bleeding tendency or tend to bruise easily. You should not take any aspirin-containing compounds, blood thinners such as Coumadin, or arthritic medicine for 7 days prior to the procedure. If you are on any of these medications that must be discontinued, please notify your doctor. Patients with liver disease may need blood tests done before the procedure.

The ultrasound portion of the procedure requires the insertion of a rectal probe. This is slightly larger than a finger and usually no more uncomfortable than a rectal examination. The probe then sends out harmless ultrasound waves that are reflected back from the prostate tissue, computerized in a highly sophisticated manner, and reproduced as an image on a television screen. With this technique, we are able to see the internal structure of the prostate gland. Transrectal ultrasound carries no known adverse risks to the patient except for occasional discomfort during the procedure.

The biopsy involves passage of a needle directly through the rectal wall and does not require anesthesia. The course of the needle is followed by the rectal ultrasound probe until the needle is lined up accurately with the suspecious area of the prostate. Several needle cores of tissue are taken and submitted to the pathologist for microscopic examination. The procedure itself entails only minimal discomfort.

As with most surgical procedures, complications, although rare, do occur. Some of these include bleeding, infection, and inability to urinate. The procedure, however, is safe and routine. Your doctor believes that any risks involved in the biopsy are much less than the risk of failing to diagnose prostate cancer.

It is possible to miss the lesion with the biopsy needle. Therefore, a patient may have a negative biopsy even though cancer is present. Sometimes repeat studies are required in highly suspicious cases.

1. Give yourself a Fleet enema two hours before the procedure time. You can purchase one at any pharmacy or grocery store. If your location and travel time interfere with this, just be sure the enema is used no closer than one hour to the appointment time. It can be longer than two hours, if necessary.
2. You may eat and drink prior to the procedure.
3. You can't take any aspirin, aspirin-containing compounds, blood thinners such as Coumadin or arthritic medications seven days prior to the procedure. Follow your doctors instructions.
4. You may want to have someone drive you home after the procedure.

If you have had hip or knee replacement or heart valve surgery, you may need an antibiotic shot the day of the procedure. Please inform the doctor if this is the case.

After the procedure, expect some blood in your bowel movements and urine, and bloody or rusty-colored semen for a while. Phone the office immediately if you are concerned about anything, especially heavy bleeding, a fever of 100 degrees or above, or significant illness.

The biopsy results will be back in 7-10 days.