What You Need To Know About The Prostate Does A Prostate Biopsy Damage The Prostate
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Day Before Prostate Biopsy
You will be given a prescription for an antibiotic that should be the day before and the morning of your biopsy. Enough antibiotics have been given for you to continue taking them for two more days after the biopsy. You will also have to purchase two fleets enemas at your local pharmacy. Follow the instructions in the box and take one the evening before and one two hours before your biopsy. You should also not eat any solid foods after dinner the night before your biopsy. You may drink any type of liquid that you choose right up to the point of your biopsy. It helps to have some fluid in the bladder during the biopsy.
Ali Atan1* Ersin Koseoglu2 And Altug Tuncel2
1Department of Urology, Gazi University, Ankara, Turkey2Department of Urology, Ankara Numune Training and Research Hospital, Ankara, Turkey
*Corresponding author: Ali Atan, MD, Professor, Department of Urology, Gazi University, Emniyet, 06560 Yenimahalle/Ankara, Turkey, Tel: +90 312 202 4444, Fax: +90312 2213202, E-mail: Int Arch Urol Complic, IAUC-2-018, , Review Article ISSN: 2469-5742Received: July 31, 2016 | Accepted: September 24, 2016 | September 26, 2016Citation: Atan A, Koseoglu E, Tuncel A The Effect of Prostate Biopsy on Erectile Functions. Int Arch Urol Complic 2:018. 10.23937/2469-5742/1510018Copyright:© 2016 Atan A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Erectile dysfunction, Prostate cancer, Prostate needle biopsy, Repeat prostate biopsy, Saturation prostate biopsy
PCa is the most common malignancy among men in the United States of America . Digital rectal examination and PSA are the first investigations for the diagnosis of PCa . PCa could only be diagnosed exactly by tissue examination. In recent years, the serum PSA measurement and number of prostate biopsies performed have become more frequent. Tissue samples should be taken from different parts of prostate by transrectal prostate biopsy and these samples should be examined histopathologically.
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Imaging Tests For Prostate Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures
- To look for spread of prostate cancer to other parts of the body
Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.
The imaging tests used most often to look for prostate cancer spread include:
What Does A Prostate Biopsy Involve
If you decide to have a biopsy, youll either be given an appointment to come back to the hospital at a later date or offered the biopsy straight away.
Before the biopsy you should tell your doctor or nurse if youre taking any medicines, particularly antibiotics or medicines that thin the blood.
You may be given some antibiotics to take before your biopsy, either as tablets or an injection, to help prevent infection. You might also be given some antibiotic tablets to take at home after your biopsy. Its important to take them all so that they work properly.
A doctor, nurse or radiologist will do the biopsy. There are two main types of biopsy:
- a trans-rectal ultrasound guided biopsy, where the needle goes through the wall of the back passage
- a transperineal biopsy, where the needle goes through the skin between the testicles and the back passage .
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How To Make Your Prostate Biopsy Go Better
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Before a prostate biopsy, discuss all thesteps you or your doctor can take to makethe experience as comfortable, safe, andinformative as possible. Image: Wavebreakmedia Ltd/Getty Images |
Here is what men need to know to minimize discomfort of a prostate biopsy and get the best results.
Many men choose to have prostate-specific antigen blood tests to check for hidden prostate cancer, despite the uncertain benefits. Having an abnormal result often leads to a prostate biopsythe only way to confirm the presence of cancer. Biopsies are invasive, but they have become routine.
To reduce discomfort and get the best results, discuss the procedure in detail with your doctor. Certain practices can improve the overall outcomefor example, make sure you get a shot of anesthetic into the prostate to numb pain during the procedure. “Local anesthesia makes a world of difference between having a tolerable biopsy experience and an unpleasant one,” says Dr. Marc B. Garnick, Gorman Brothers Professor of Medicine and a prostate cancer expert at Harvard-affiliated Beth Israel Deaconess Medical Center.
Dealing With Bph Since 2003
Based on the experience of 2003, I will never again have a prostate biopsy. Since having my left cancerous kidney removed in April of 2015, the condition of my prostate has been monitored by more PSA tests and semi-annual prostate sonograms. My new urologist has me on the drug Avodart containing dutasteride to help shrink the prostate and another, Harnal containing tamsulosin hydrochloride, which makes it easier for me to urinate during the night.
This content is accurate and true to the best of the authorâs knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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What To Watch For Afterward
Here are the most common complications of prostate biopsy:
- Blood in your urine for a few days to several weeks.
- Blood in the stool for a day or so. If it lasts longer, notify your physician.
Make sure to notify your doctor if rectal or urinary bleeding get worse. Also, be on guard in the first 24 to 48 hours for signs of a serious infection in the urinary tract or prostate gland. “The alarm signs are fever or chills,” Dr. Garnick says. “If you experience this, get to a hospital immediately for intravenous antibiotics.” A runaway infection can be dangerous, so don’t ignore the signs.
Another uncommon but dangerous complication is urinary retentionthe inability to pass urine caused by an infection. Seek care immediately if you stop being able to urinate after a biopsy.
Image: Alex011973/Getty Images
What Is A Trus Biopsy
This is the most common type of biopsy in the UK. The doctor or nurse uses a thin needle to take small samples of tissue from the prostate.
Youll lie on your side on an examination table, with your knees brought up towards your chest. The doctor or nurse will put an ultrasound probe into your back passage , using a gel to make it more comfortable. The ultrasound probe scans the prostate and an image appears on a screen. The doctor or nurse uses this image to guide where they take the cells from. If youve had an MRI scan, the doctor or nurse may use the images to decide which areas of the prostate to take biopsy samples from.
You will have an injection of local anaesthetic to numb the area around your prostate and reduce any discomfort. The doctor or nurse then puts a needle next to the probe in your back passage and inserts it through the wall of the back passage into the prostate. They usually take 10 to 12 small pieces of tissue from different areas of the prostate. But, if the doctor is using the images from your MRI scan to guide the needle, they may take fewer samples.
The biopsy takes 5 to 10 minutes. After your biopsy, your doctor may ask you to wait until you’ve urinated before you go home. This is because the biopsy can cause the prostate to swell, so they’ll want to make sure you can urinate properly before you leave.
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What Are The Side Effects Of A Biopsy
Having a biopsy can cause side effects. These will affect each man differently, and you may not get all of the possible side effects.
Pain or discomfort
Some men find the biopsy painful, but others have only slight discomfort. Your nurse or doctor may suggest taking mild pain-relieving drugs, such as paracetamol, to help with any pain.
If you have any pain or discomfort that doesnt go away, talk to your nurse or doctor.
Short-term bleeding
A small number of men who have a TRUS biopsy may have more serious bleeding in their urine or from their back passage . This can also happen if you have a transperineal biopsy but it isn’t very common. If you have severe bleeding or are passing lots of blood clots, this is not normal. Contact your doctor or nurse at the hospital straight away, or go to the accident and emergency department at the hospital.
Infection
Some men get an infection after their biopsy. This is more likely after a TRUS biopsy than after a transperineal biopsy. It’s very important to take any antibiotics youre given, as prescribed, to help prevent this. But you might still get an infection even if you take antibiotics.
Symptoms of a urine infection may include:
- pain or a burning feeling when you urinate
- dark or cloudy urine with a strong smell
- needing to urinate more often than usual
- pain in your lower abdomen .
If you have any of these symptoms, contact your doctor or nurse at the hospital straight away. If you cant get in touch with them, call your GP.
Pathophysiology Of Erectile Dysfunction And Prostate Biopsy
The risk of developing temporary erectile dysfunction is largely dependent on the number and volume of tissue samples obtained during the procedure. Needless to say that the risk is greater if more biopsies are taken.
There are three primary types of prostate biopsies a typical standard one utilizes only 1 needle to take no more than 10 samples. The risk of complications like erectile dysfunction is higher if more than 10 tissues samples are obtained or if any type of nerve block is used for pain reduction.
According to a new study, investigators evaluated the risk of erectile dysfunction in men who undergo prostate biopsy. 25% of men in the study sample who underwent standard saturation biopsy admitted that they had erectile dysfunction before the biopsy but the percentage went up to 50% just a week after the procedure. The group in which men had nerve block, erectile dysfunction rate raised to 39% from 11% after the biopsy. However, by12th week post-procedure, the transient erectile dysfunction resolved in the study sample suggesting no nerve damage or dysfunction takes places during the procedure.
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Positron Emission Tomography Scan
A PET scan is similar to a bone scan, in that a slightly radioactive substance is injected into the blood, which can then be detected with a special camera. But PET scans use different tracers that collect mainly in cancer cells. The most common tracer for standard PET scans is FDG, which is a type of sugar. Unfortunately, this type of PET scan isnt very useful in finding prostate cancer cells in the body.
However, newer tracers, such as fluciclovine F18, sodium fluoride F18, and choline C11, have been found to be better at detecting prostate cancer cells.
Other newer tracers, such as Ga 68 PSMA-11, 18F-DCFPyl , and Ga 68 gozetotide , attach to prostate-specific membrane antigen , a protein that is often found in large amounts on prostate cancer cells. Tests using these types of tracers are sometimes referred to as PSMA PET scans.
These newer types of PET scans are most often used if its not clear if prostate cancer has spread. For example, one of these tests might be done if the results of a bone scan arent clear, or if a man has a rising PSA level after initial treatment but its not clear where the cancer is in the body. PSMA PET scans can also be used to help determine if the cancer can be treated with a radiopharmaceutical that targets PSMA.
Doctors are still learning about the best ways to use these newer types of PET scans, and some of them might not be available yet in all imaging centers.
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Does Prostate Biopsy Increase Psa
Although prostate biopsy is used to determine the presence of prostate cancer, the procedure itself causes various risks, and increased PSA is one of them.
Evidence shows both prostate biopsy and transurethral resection of the prostate cause an instant elevation of serum PSA level.
It may take up to three weeks for PSA to stabilize and return to baseline concentration. However, in one study, PSA remained increased in participants even four weeks after prostate biopsy.
For that reason, a prostate biopsy is even riskier than we are led to believe. Even though some doctors may say PSA will return to normal soon, that doesnt always happen. So, if you have another test a few weeks or months later, the results may not be accurate.
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How We Approach Prostate Biopsies And Prostate Cancer Diagnosis At Ctca
When you come to CTCA for a prostate biopsy or a second opinion, youll have access to tests that may help increase the accuracy of each biopsy. Our team has expertise with these tests and procedures, allowing us to work quickly and efficiently.
If youre diagnosed with prostate cancer, a multidisciplinary team of genitourinary experts, which may include a urologist, a urologic oncologist, a radiation oncologist and a medical oncologist, will review your case and develop a personalized plan based on your specific circumstances and needs.
We only treat cancer at CTCA, which means our cancer experts are skilled at assessing risk associated with each persons circumstances. We give you the pros and cons of the treatment options available to you, allowing you time to talk with your team of doctors and other experts about those options.
Our cancer experts are also vigilant about what patients need and when they need it. We know that when men are told they have slow-growing prostate cancer, some of them wont keep up with the necessary follow-ups, so we help keep them on track.
If you choose to receive treatment with us, you may benefit from our integrative approach to cancer treatment. Our multidisciplinary team works together to help prevent and manage the side effects of cancer and its treatment, providing supportive care services, such as:
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Transrectal Ultrasound Scan Guided Biopsy
Your doctor takes a series of small tissue samples from the prostate to examine under a microscope. You have the biopsy through the back passage using a transrectal ultrasound scanner.
A TRUS guided biopsy can be uncomfortable. You usually have a local anaesthetic to numb the area and reduce any pain.
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What Have Randomized Trials Of Prostate Cancer Screening Found
Several large, randomized trials of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and digital rectal exam were evaluated for their ability to decrease a mans chances of dying from prostate cancer.
The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but had about the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.
A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .
The United States Preventive Services Task Force has estimated that, for every 1,000 men ages 55 to 69 years who are screened for 13 years :