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Transrectal Prostate Ultrasound and Biopsy

Ultrasound uses harmless sound waves to give us pictures of the prostate and allows us to accurately guide a biopsy needle to areas of concern. Indications for prostate biopsy include suspicion for cancer either by suspicious finger exam of the prostate or by elevation of a prostate cancer screening blood test (PSA). The procedure is done in the office without the need for anesthesia. Initially, a complete finger exam is done. Next the ultrasound probe is placed in the rectum. With slight movement of the probe, many different views are obtained. When areas of suspicion are seen, biopsies will be taken and/or random biopsies are obtained if no suspicious areas are seen. A spring loaded fine needle is placed through the probe and directed to the area to be biopsied. Approximately, 6-12 biopsies are obtained. The entire exam takes about 10-20 minutes. You may have some soreness around the rectum for up to one hour. You may also notice blood in the urine and stool for several days to weeks, and blood in the semen for a few months. After the procedure please call within 24 hours to set up a follow up visit 10 days after the procedure to go over biopsy results.

POSSIBLE RISKS OF PROSTATIC ULTRASOUND AND BIOPSY:

Blood may be noted in this stool and urine for several days to weeks, and blood may be noted in the semen for a few months. Infection of the prostate.

Pre-Treatment:

  • No aspirin products, ibuprofen, Aleve, Naprosyn, Vitamin E, etc. for 7-10 days before the biopsy. If you are on Coumadin this will need to be held 4-5 days if okay with your prescribing physician.
  • No dietary restrictions on the day of the procedure.
  • Perform a fleet enema two hours before the visit. Buy this at any drugstore and follow the instructions on the package.
  • Please take your antibiotics as directed. Either samples or a prescription will be given to you.

When you get home:

Activity

Limit your activity, particularly strenuous ones, for 24 hours. Staying off your feet until the next morning is probably a good idea.

Side Effects:

Please take your antibiotic pills as directed.

Increase your fluid intake for the next 1-2 days to decrease formation of blood clots in your urine. If your urine is completely clear for the first few urinations, you will probably not have to worry about this. Some spotting of the urine with blood may occur for the first several weeks -- not to worry, it will go away.

You may experience discomfort in the rectum or base of your penis. This is normal and should be of no concern. In addition, you may have a small amount of blood in your stool when you have a bowel movement, and you may notice blood on your toilet paper.

You may also notice blood or discoloration in your semen if you are sexually active. This is also normal and may last for a few months until the blood is cleared out of your prostate.

IT IS IMPORTANT THAT YOU CONTACT US AS SOON AS POSSIBLE IF ANY OF THE FOLLOWING SYMPTOMS OCCUR:

  • Burning with urination
  • Chills
  • Fever
  • Large blood clots or excess of blood in the urine or stool
  • Difficulty or inability to urinate

Follow Up:

After the procedure please call within 24 hours to set up a follow up visit 10 days after the procedure to go over biopsy results.