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How Do You Do A Prostate Biopsy

Is Having Blood In My Semen Dangerous

How is a Prostate Biopsy Performed?

Although its frightening to see blood in your semen, its rarely a symptom of a major health problem. A single episode of blood in your semen is usually not a sign of cancer. However, you may still want to see your healthcare provider to be reassured, to fully discuss this symptom and get an exam and perhaps other tests if your provider thinks theyre needed.

Other Cancer Treatment Effects On Ejaculation

Some cancer treatments reduce the amount of semen thats produced. After radiation to the prostate, some men ejaculate less semen. Toward the end of radiation treatments, men often feel a sharp pain as they ejaculate. The pain is caused by irritation in the urethra . It should go away over time after treatment ends.

In most cases, men who have hormone therapy for prostate cancer also make less semen than before.

Chemotherapy and other drugs used to treat cancer very rarely affects ejaculation. But there are some drugs that may cause retrograde ejaculation by damaging the nerves that control emission.

Whats The Purpose Of A Transrectal Ultrasound

A transrectal ultrasound is a procedure that produces an image of the prostate. Its usually ordered after an abnormal PSA and DRE. For the test, a small probe is inserted into the rectum. The probe then uses sound waves to produce a picture on a computer screen.

The test is uncomfortable, but not painful. It can be done in your doctors office or on an outpatient basis in about 10 minutes. It can help estimate the size of the prostate and spot abnormalities that may indicate cancer. However, a TRUS cant confirm the diagnosis of prostate cancer.

A TRUS can also be used to guide a biopsy.

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Prostate Biopsy: How It Works

The instrument used to perform most prostate biopsies today is a spring-loaded device that pokes a hollow needle through the rectal wall to collect small samples of prostate tissue, guided by an ultrasound or MRI.

The samples are quite smalljust several times the diameter of the lead in a mechanical pencil. Later, a pathologist checks the samples under a microscope for signs of cancer.

Prostate biopsy comes with certain risks. For example, when the biopsy needle passes through the rectal wall to reach the prostate, it can spread a bacterial infection to the prostate gland or bloodstream.

What Does A Digital Rectal Exam Do

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In a digital rectal exam , the doctor inserts a gloved finger into your rectum to feel for irregularities of the prostate. Its a common part of a mans routine physical examination.

Your doctor might perform a DRE alone or with a PSA test for routine screening. Its a quick and simple test. Although a DRE can signal a problem, such as an enlarged prostate, it cannot determine if its due to prostate cancer.

Prostate cancer is diagnosed 15 to 25 percent of the time when abnormal findings on a DRE lead to biopsy.

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How Should You Prepare For A Prostate Ultrasound And Biopsy

Preparation for a prostate ultrasound and biopsy is simple. You shouldnt take any blood-thinning medications such as warfarin , clopidogrel , aspirin or ibuprofen before a prostate biopsy because blood thinner increase the risk of bleeding. If you are already taking blood thinners, your doctor will discuss with you how many days prior to the biopsy they should be held.

Most healthcare providers dont ask you to follow any type of special diet before a biopsy. However, they suggest eating lightly before the procedure and drinking only clear liquids. Check with your providers office to see if you need to do anything additional to prepare for the test.

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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What Is Prostate Cancer

Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.

Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.

Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.

Ask your doctor to use this picture to show you where your cancer is.

The prostate

The prostate is a gland found only in men, so only men can get prostate cancer.

The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.

There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.

How Do You Prepare For A Prostatebiopsy

How Safe is Prostate Biopsy?

If you were ordered a prostate biopsy, its because your doctor examined your case and determined that youre a candidate. He has probably told you what it is about, which method hes going to use, and how it will be like. But if you havent discussed everything with your doctor, that is one of the first things on your list. Talk to your doctor and ask him any question you have. Every one of us has different traits and risk factors. You may need specific advice according to your case.

You will probably undergo these preparation steps before a prostate biopsy:

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My Prostate Biopsy Showed No Cancer But There Was High

High-grade prostatic intraepithelial neoplasia and atypical glands are sometimes precancerous changes, as about 25-30% of patients who have them may later be diagnosed with prostate cancer. Sometimes the conversion can take 10 years or more. My policy is to check the patients Prostate Health Index blood test quarterly for the next year and then decide whether a follow-up biopsy is indicated to rule out the development of cancer.

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How Is The Biopsy Procedure Performed

Ultrasound-guided biopsy procedure:

The ultrasound-guided prostate biopsy is carried out by a radiologist or urologist, assisted by a sonographer and often a nurse who helps look after the patient.

You may have a small enema inserted into your rectum half an hour or so before the procedure to clean out your bowels and clear the rectum of feces so that the prostate may be seen more clearly with the ultrasound and to lower the risk of infection.

You may also be given antibiotics just before the procedure as an additional safeguard against infection. You also may receive medication for pain and anxiety. Sometimes an injection of local anesthetic or sedative will be given in the area of the rectum to minimize discomfort during the procedure.

The procedure is often carried out after you have been given a light general anesthetic, which means you will be asleep or sedated during the procedure. If the procedure is carried out using an anesthetic, an anesthesiologist will be present.

During the procedure, you will be asked to lie on your left side with your legs bent.

The physician will first carry out a DRE with a gloved finger.

An ultrasound probe will then be inserted into your rectum. The probe is sterilized, covered with condoms to ensure protection from any infection or contamination, and lubricated to help it glide easily into your rectum.

The entire ultrasound-guided biopsy procedure is usually completed within 45 minutes or less.

MRI-guided biopsy procedure:

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What Is A Transperineal Biopsy

This is where the doctor inserts the biopsy needle into the prostate through the skin between the testicles and the back passage . In the past, hospitals would only offer a transperineal biopsy if other health problems meant you couldnt have a TRUS biopsy. But many hospitals have stopped doing TRUS biopsies and now only do transperineal biopsies.

A transperineal biopsy is normally done under general anaesthetic, so you will be asleep and wont feel anything. A general anaesthetic can cause side effects your doctor or nurse should explain these before you have your biopsy. Some hospitals now do transperineal biopsies using a local anaesthetic, which numbs the prostate and the area around it, or a spinal anaesthetic, where you cant feel anything in your lower body.

The doctor will put an ultrasound probe into your back passage, using a gel to make this easier. An image of the prostate will appear on a screen, which will help the doctor to guide the biopsy needle.

If youve had an MRI scan, the doctor may just take a few samples from the area of the prostate that looked unusual on the scan images. This is known as a targeted biopsy.

When Can I Expect The Results Of My Ultrasound Guided Prostate Biopsy

Men over 40 â getting tested for prostate cancer is so ...

The pathology result generally takes a few days to be available to your doctor.

The time it takes your doctor to receive a written report on the test or procedure will vary depending on:

  • the urgency with which the results are required by your doctor
  • the complexity of the test or procedure
  • whether more information is needed from your doctor before the test or procedure can be interpreted by the radiologist
  • whether you have had previous X-rays or other medical imaging that need to be compared with this test or procedure
  • how the report is sent to your doctor .

Please feel free to ask the private practice, clinic, or hospital when the written report will be provided to your doctor.

It is important that you discuss the results with your doctor, either in person or on the telephone, so that they can explain what the results mean for you.

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What Happens After A Prostate Biopsy

Your recovery process will vary depending on the type of anesthesia that isused. If you were given general anesthesia, you will be taken to a recoveryroom for observation. Once your blood pressure, pulse, and breathing arestable and you are alert, you will be taken to your hospital room ordischarged to your home.

If local anesthetic was used, you may go back to your normal activities anddiet unless otherwise instructed. You may feel the urge to urinate or havea bowel movement after the biopsy. This feeling should pass after a fewhours.

There may be blood in your urine or stool for a few days after the biopsy.This is common. Blood, either red or reddish brown, may also be in yourejaculate for a few weeks after the biopsy. This, too, is normal.

The biopsy site may be tender or sore for several days after the biopsy.Take a pain reliever for soreness as recommended by your healthcareprovider. Aspirin or certain other pain medicines may increase the chanceof bleeding, so be sure to take only recommended medicines.

  • Increase in the amount of blood in your urine or stool

  • Belly or pelvic pain

  • Trouble urinating

  • Changes in the way your urine looks or smells or burning with urination

  • Fever and/or chills

Your healthcare provider may give you other instruction, depending on yoursituation.

Are There Any Problems To Expect After A Prostate Ultrasound And Biopsy

In some cases, men can develop a urinary tract infection or an infection in the prostate. These infections are rare and easy to treat with prescribed antibiotics.

Blood in the urine and/or stool is common for three to five days after the biopsy. It is also common to have blood in your semen for up to two to three months after the biopsy. This is not harmful to you or your partner and will eventually go away on its own. You should avoid heavy lifting for two to three days to help avoid bleeding issues.

Some men may also have trouble urinating after the procedure. Most problems are minor and go away on their own after a few days. If you arent able to urinate at all, call your healthcare provider or go to the emergency room. Make sure that you tell them that you just had the ultrasound and biopsy.

  • A fever of 100 degrees F or higher.
  • Shaking or chills.

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Pain During Erection Or Ejaculation

Some men find that erections and ejaculating is painful after surgery, or during and after their course of radiotherapy.

Painful erections following surgery could be due to internal bruising caused by the operation. The tube which carries urine from the bladder to the outside of the body gets inflamed by the radiotherapy treatment.

This side effect should disappear a few weeks after you finish radiotherapy or as you recover from surgery. Talk to your specialist nurse for specific advice. If masturbation and sex is important to you, its important to keep stimulating the penis to keep it healthy. On the other hand, if erections are very painful, you might need to avoid ejaculation for a while and try again later.

The penile injections to stimulate an erection can cause painful erections in some men. This pain might lessen with continued treatment.

Temporary Effects On Your Bowel Movements Urine And Semen

When should You Have a Prostate Biopsy?
  • You might see blood in your bowel movements. You might also have a small amount of bleeding from your rectum. These can happen right after your procedure or for the next few days when you have a bowel movement.
  • You might see blood in your urine for 7 to 14 days after your procedure. This bleeding might come and go.
  • Your semen might look rust-colored for up to 12 weeks after the biopsy. This is because small amounts of blood might be in it.

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How To Get The Best Results

Most men do not find prostate biopsy excessively painful or uncomfortable, and the complications are usually not seriousbut can be. Certain steps taken before, during, and after the procedure can improve the outcome:

Take antibiotics. Taking preventive antibioticsbefore and after the procedurecuts the risk of infection substantially. Most infections are not dangerous but could become so if they get out of control. The overall chance of being hospitalized with an infection after prostate biopsy is 1% to 3%.

Review medications. Before the biopsy, your doctor may advise you to stop taking daily low-dose aspirin or an anticoagulant such as warfarin , dabigatran , edoxaban , rivaroxaban , or apixaban . These drugs reduce the bloodâs ability to clot. Your doctor will weigh the chance of bleeding against the need for anticoagulants to prevent heart problems or stroke.

Expect anesthesia. Get local anesthesia for the biopsy. This means an injection of a numbing drug into the prostate gland to reduce pain during the biopsy.

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Adverse Effects Of A Prostate Biopsy

The majority of men undergo prostate biopsy with few or no significant problems at all. However, some men do have problems, and a good physician will be sympathetic to these problems if they occur:

  • While many men have little or no pain associated with a prostate biopsy, for some men there can be significant pain. It is possible that such pain is associated with the biopsy needle cutting into or through nerves that run through the prostate tissue.
  • Minor bleeding may occur after a biopsy, and evidence of blood in the urine and the semen post-biopsy is very common. Rectal bleeding is also a possibility. The patient should be encouraged to avoid heavy work or exercise for 24 hours after a biopsy. If there is significant and continued bleeding, a patient should immediately contact the doctors office.
  • Difficult with urination is also a possible complication. In this case also, the doctors office should be informed immediately.
  • Infection associated with a prostate biopsy is a relatively rare but very possible complication. If the patient develops a high fever, and complains of chills or abdominal pain after the procedure, he should arrange to see the doctor right away.

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How Should I Prepare

Prior to a prostate biopsy, you should provide your physician with a list of all the medications you are taking, including herbal supplements. Tell your doctor if you have any allergies, especially to anesthesia. Also, inform your physician about recent illnesses or other medical conditions.

You may be asked to stop or curtail the use of blood thinning medications for seven to 10 days before the procedure to prevent excessive bleeding during and after the biopsy. A blood test may be required to check your blood clotting on the day of the procedure. Consult your physician and the hospital radiology clinic or department for more information.

You may be advised to take antibiotic pills for a day or two before the biopsy, and on the morning of the procedure, to help prevent infection.

If you are undergoing an MRI-guided biopsy, you will be asked to wear metal-free clothing and remove any metallic objects, such as jewelry, watches, and hearing aids.

A technologist will walk through an MR imaging safety checklist with you. Make sure to inform your technologist of prior surgeries or metal implants, such as pacemakers, aneurysm clips, or joint replacements.

For the MRI-guided procedure, you will receive intravenous contrast material called gadolinium. Because gadolinium does not contain iodine, it can be used safely in patients with contrast allergies.

If you are sedated for the procedure, you will want to have a relative or friend accompany you and drive you home afterward.

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