Do you need a prostate biopsy? Now, you may have options. A prostate biopsy is a short (15-minute) medical procedure used to obtain tissue samples from the prostate for examination, typically to check for prostate cancer. It involves using a needle to remove small pieces of tissue from the prostate gland. The tissue samples collected are then examined under a microscope to check for signs of cancer or other abnormalities.
With a traditional prostate biopsy, called a transrectal biopsy, a needle is guided through the wall of the rectum and into the prostate to gather the tissue. This procedure is safe, has been used for decades and is still the gold standard for prostate biopsies. There is, however, a small very small chance of infection due to the needle being introduced through the rectum in a traditional biopsy. There is an alternative approach, called a transperineal biopsy, that can gather a sample of the prostate tissue without going through the rectal wall.
This new type of biopsy is called “transperineal” because the needle is inserted through the perineum, which is the area of skin between the scrotum and anus. The patient doesn’t need to undergo a bowel prep for this procedure as compared to the traditional transrectal approach. The biopsy may be done under sedation, or, if not, the patient is given a local anesthetic to numb the perineum and the area around the prostate. The doctor will use a thin, hollow needle to collect small tissue samples from different areas of the prostate. This is often guided by ultrasound to ensure accurate placement of the needle. At Conrad Pearson, we currently use the PrecisionPoint® Transperineal Access System, from Perineologic®, to guide the needle, allowing the doctor to keep the needle in view at all times.
Patients who may be candidates for the transperineal biopsy include those with a prior history of post biopsy infection/sepsis or anatomical issues that would make a transrectal biopsy difficult or not possible. There is also potentially a lower risk of infection compared to the transrectal approach because the needle does not go through the rectum. A transperineal biopsy can also be advantageous in detecting cancer in certain locations of the prostate, notably in the anterior portion of the prostate, potentially benefitting patients who have had prior negative transrectal biopsy but still have elevated PSA. After the procedure, there might be some discomfort or mild swelling, but these symptoms usually subside in a short period. Patients are typically monitored for any complications, such as infection or bleeding.
While patients don’t often notice a difference in the type of biopsy, men do sometimes seek out this procedure. Dr. Matthew Sims at the Conrad Pearson Clinic is sought after for his expertise in transperineal biopsies and has been trained in and performing biopsies in this way for over five years.
