Prostate Biopsy

A prostate biopsy is an examination method that involves taking cells from the prostate tissue. It plays a key role especially in the diagnosis of prostate cancer. It is not possible to diagnose prostate cancer without a biopsy and subsequent histological examination. In the case of the prostate, the doctor may suspect a tumour based on palpation or, in particular, based on an increased PSA concentration, but only a tissue analysis will confirm or refute their suspicion. Even in cases where a malignant tumour is not present, a biopsy and subsequent analysis of the tissue will provide information about the nature of the tissue changes, and we can decide on further treatment based on these findings.

The biopsy is performed with a special biopsy needle using an ultrasound probe inserted into the rectum. During the examination, an ultrasound probe is first introduced into the rectum, which helps to determine the places from which the tissue is taken. The tissue collection is carried out from approximately 10 to 12 places of the prostate. The examination is not painful, but rather uncomfortable, so you can ask the doctor who will perform the biopsy for analgesia. The time required for the examination is usually 10 to 15 minutes.

Before the examination, a thorough emptying of the rectum (preferably with the help of glycerine suppositories) and in some cases also the administration of antibiotics is necessary. If you are taking blood thinners, these medications must be discontinued 5 days in advance, in agreement with your general practitioner or specialist, or replaced with other, more suitable medications.

The collected tissue samples are then sent for a histological examination, which refutes or confirms the presence of tumour cells.

We currently have three methods of prostate biopsy:

• A standard prostate biopsy, in which the doctor takes samples of prostate tissue from you through a special rectal ultrasound probe.
• Trans-perineal biopsy of the prostate, which, compared to standard biopsy, uses a more advanced ultrasound probe connected to a “stepper”, a device intended for fixing the probe and its precise manipulation. This type of biopsy is performed through the perineum, is precisely targeted, and has a lower risk of subsequent infection and bleeding.
• Prostate fusion biopsy involves data acquisition from two different sources, magnetic resonance (MR) and ultrasound. It works such that a suspicious lesion in the prostate is identified through MRI scan, and the resulting image is then linked to an ultrasound. Linking these two images enables more precise targeting of the pathological lesion and its safe removal. The technology of fusion biopsy allows capturing the lesion in several planes. This increases the possibility of capturing even very small lesions. This biopsy modality is performed through the perineum, similar to the trans-perineal biopsy of the prostate.