Transrectal Ultrasound (TRUS) Guided Biopsy of Prostate

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What is Transrectal Ultrasound Guided Biopsy of Prostate?

TRUS guided biopsy of the prostate is currently the most common prostate biopsy method. It is usually recommended when you have an elevated PSA (Prostate Specific Antigen) blood test, an abnormal digital rectal examination (DRE) of the prostate, or both an elevated PSA and an abnormal DRE. In this method, the doctor inserts a small ultrasound probe into the rectum to guide placement of a special biopsy needle for taking sample of the prostate. The procedure usually takes about 20 minutes in your urologist's office under local anesthesia. Sedation or pain medication may also be given.

The risk of TRUS guided biopsy may include, but are not limited to the following
- Bleeding: It is common to see blood in the urine, stool, semen. However, severe bleeding is rare
- Infection: It is rare, but may include sepsis (severe infection with bacteria in the blood stream) that may require further treatment and hospitalization
- Pain: May occur during and after the biopsy; however, local anesthesia usually will provide comfort during and after the procedure
- Urinary Retention (unable to urinate): Occurs rarely

TRUS guided biopsy of the prostate allows the doctor to identify cancer in the prostate. If there is cancer, the doctor will be able to know the grade (or aggressiveness of cancer)

Alternatives to TRUS guided biopsy include, but are not limited to the following. You should discuss with your doctor these alternatives:
- Not having the procedure performed
- Biopsy using other methods such as transperineal approach (biopsy with a needle through the skin between the scrotum and the anus)
- MRI (Magnetic Resonance Imaging) with ultrasound fusion method (the method that uses MRI imaging information combined with ultrasound technology to guide the biopsy of the prostate)

You should let your doctor know of any and all allergies and medications that you are currently taking including over the counter medications such as: aspirin, Ibuprofen, naproxen, blood thinners (you should ask your doctor when you should stop blood thinner before the operation).
You should take antibiotics before the procedure, as prescribed by your doctor. You should use a Fleet Enema (medication to be instilled into your rectum to increase bowel movement and cleanse the rectum) as directed by your doctor (usually a few hours before the procedure).
Normally, when the procedure is performed under local anesthesia, you can have a light breakfast and/or light lunch.
It is usually recommended that you have somone to drive you to and from the procedure.

You should use the bathroom, just prior to the procedure since the ultrasound probe may increase the urge of urination.

You will be asked to undress from the waist down and lie on your side with your knees toward your chest (similar to curling up like a ball).
Your doctor will routinely provide numbing gel into the rectum. The doctor will then insert the ultrasound probe into the rectum and scan the prostate on a video monitor to determine the volume of the prostate and to detect any areas of abnormalities.
You will be given local anesthesia to the prostate area to provide comfort during the biopsy. The doctor will then use a spring loaded biopsy needle to perform routinely around 8-12 biopsies or more.
The biopsy tissue is small and about the size of a mosquito larva. It will be sent to a pathologist (doctor who specializes in looking at these samples under microscope) to determine if it is cancerous. It usually takes one week to receive the results.

Have a fever more than 101 degree Fahrenheit or shaking chills, or feeling very sick