Does a Prostate Biopsy Damage the Prostate?

In order to diagnose a specific prostate disease, a doctor may order various tests. 

For example, they may request a prostate biopsy to determine whether a patient has cancer. 

Although we are told these tests are good for us, that’s not always the case. 

A prostate biopsy isn’t harmless. 

Does a prostate biopsy damage the prostate gland? What can you expect after this procedure? What are the risks? Get answers to these questions below.

What is a prostate biopsy?

Prostate biopsy is the removal of a sample of suspicious tissue from the prostate gland. Doctors often recommend a prostate biopsy to detect prostate cancer when a patient’s PSA levels are high. 

Prostate-specific antigen (PSA) is a protein made by the prostate, and it functions to cleave semenogelins (protein in semen) in the seminal coagulum. Levels of PSA are higher in the presence of prostate cancer. Other conditions that increase PSA include benign prostatic hyperplasia (enlarged prostate), infection, and prostate inflammation.

The beginnings of prostate biopsy to exclude prostate cancer date back to the early 20th century. In 1926, the first prostate biopsy using the open perineal technique was performed. During this invasive open surgery, the surgeon would automatically proceed to perform a total prostatectomy if they presumed cancer was likely. 

With time, the procedure evolved, and in 1954 new method was introduced. This time, prostate biopsy involved the insertion of a needle through the perineum one centimeter above the anus. Digit in a patient’s rectum guided the needle.

Today, a prostate biopsy is performed in two ways. One method, transrectal biopsy, involves passing a needle through the wall of the rectum. The second method, transperineal biopsy, revolves around inserting the needle through the perineum (an area between the scrotum and rectum). A transrectal biopsy is more commonly performed than the other method.

Does a prostate biopsy damage the prostate?

Yes, a prostate biopsy can damage the prostate gland. Prostate biopsy is considered a minimally invasive procedure in the sense that it doesn’t include heavy bleeding and scars. However, minimal invasiveness doesn’t automatically indicate harmlessness. 

What many doctors won’t say about prostate biopsy is that it can damage this almond-shaped gland. 

For instance, when a biopsy needle passes through the wall of the rectum to reach the prostate, it can spread the bacterial infection to this gland. The infection can also enter the bloodstream. 

Bacterial infection of the prostate causes inflammation or prostatitis. The infection can be acute or chronic. 

A man with this problem experiences a wide range of symptoms, including fever, chills, ejaculatory pain, pelvic pain, urinary changes, and other issues. 

When left unresolved, prostatitis can cause bacteremia or bacterial infection of the blood, prostatic abscess, epididymitis, or inflammation of the coiled tube attached to the back of the testicle.

Sometimes doctors prescribe antibiotics for patients to take before a prostate biopsy. The main goal is to prevent infection of the prostate. 

But even with antibiotics such as fluoroquinolones, men can still develop serious urinary tract infections and bacterial prostatitis. Why? Sometimes the bacteria that cause the infection are resistant to antibiotics.

Some men are at a higher risk of infection that damages their prostate gland. These include men with diabetes, prostatitis, urinary tract infection, and patients who use a urinary catheter. 

Besides infection, a biopsy can cause swelling of the prostate gland. A swollen prostate makes it difficult for a man to urinate properly and empty his bladder. Urinary retention increases the risk of various complications, including stretching and tearing of the bladder, incontinence, and dull pain, just to name a few.

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Can prostate biopsy damage nerves?

A prostate biopsy can damage nerves. More precisely, this procedure can damage nerves that regulate erectile function. As a result, patients may experience erectile dysfunction on top of other problems caused by this test.

One study found that prostate biopsy can impair voiding and erectile response regardless of the number of cores. The scientists concluded that doctors should inform patients about this side effect.

Interestingly, men who undergo multiple prostate biopsies are more likely to become impotent after radical prostatectomy than their counterparts who had one biopsy only. In other words, a prostate biopsy can damage nerves and impair the outcomes of the surgical procedure.

Doctors, unfortunately, fail to inform patients of all the risks of prostate biopsy. While they often say it’s painful, the information about long-term effects is often left out. 

A possible reason for this is that doctors push for prostate biopsy because it covers them if patients sue for negligence. 

How long does it take for the prostate gland to heal after a biopsy?

The recovery process after biopsy depends on factors such as a patient’s age and overall health. While doctors keep saying prostate biopsy is easy, the recovery process isn’t that simple. 

It may take four to six weeks to recover. For some men, it can take longer than that, even when they adhere to all the instructions. 

Side effects and risks of a prostate biopsy

Side effects and risks associated with prostate biopsy are common and generally include:

  • Rectal bleeding
  • Pain 
  • Blood in the semen
  • Difficulty urinating
  • Blood in urine
  • Infection of the urinary tract or prostate

In one study, around 40% of patients experienced complications after prostate biopsy. The complication rate was 57% among men with 24-sample biopsies. 

The findings also showed that 6.7% of patients developed acute urinary retention, 9.1% visited an emergency room after prostate biopsy, and 1.2% required hospitalization. The most common side effects of prostate biopsy in this study were pain, infection, and soreness.

While many doctors tend to say the abovementioned adverse reactions are short-term, the reality is different. Men who undergo prostate biopsy experience pain, incontinence, and other problems for a longer period, and it affects their quality of life.

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What are the long-term effects of a prostate biopsy?

The long-term effects of a prostate biopsy require thorough studies and large sample sizes. 

One example of a long-term effect is that prostate biopsy can encourage the growth of prostate cancer cells that spread to other tissues. A prostate biopsy can elevate PSA levels and damage the prostate, thus turning a small, non-aggressive cancer into a more serious problem.

Although prostate biopsy is dubbed the most effective test to detect prostate cancer, the reality is different. The needle takes out a small core of tissue, so it’s relatively easy to miss cancer. 

That explains why some men need multiple biopsies and go through excruciating pain every time. And still, it may not be enough to detect prostate cancer in its early stages. 

In a nutshell, the long-term effects of prostate biopsy relate to even more aggressive diseases in the long run. Of course, another one of the long-term effects of prostate biopsy is erectile dysfunction due to nerve damage. 

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 (TURP) 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 doesn’t always happen. So, if you have another test a few weeks or months later, the results may not be accurate.

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What to expect after a prostate biopsy

Pain is safe to expect after a prostate biopsy. Patients tend to feel significant discomfort and pain, which is why doctors advise them to do only light activities 24 to 48 hours after the procedure.

As mentioned above, prostate biopsy carries the risk of infection. You will be given antibiotics to take for several days in order to reduce the risk of this side effect. 

Following a prostate biopsy, patients can also expect to have blood in urine and stool for several days. Your semen may appear reddish or rust-colored due to the presence of blood.

Sometimes pain worsens instead of getting better. If that happens, you should call your doctor or go to the ER. This is especially important if you also have a fever and prolonged or heavy bleeding. 

Alternatives to a prostate biopsy

Prostate biopsy is not the only option to detect the presence of prostate cancer. That’s why it’s possible to avoid this procedure. Some of the best prostate biopsy alternatives are listed below.

Digital rectal exam (DRE)

A digital rectal exam is a test during which a doctor examines a patient’s pelvis, lower rectum, and lower abdominal area. The test allows a doctor to check for prostate cancer. 

To perform a DRE, a doctor inserts a gloved finger into the rectum to detect prostate gland abnormalities. A digital rectal exam is quick and simple. 

It’s uncommon for doctors to use DRE alone because prostate abnormalities occur due to several reasons besides cancer. For instance, BPH can also make the prostate appear abnormal to the touch. 

The free prostate-specific antigen test

A doctor orders a free PSA test to confirm the results of the PSA test. Remember, elevated levels of PSA could indicate the presence of prostate cancer. 

It’s important to remember that PSA and free PSA are not the same. While PSA has bound to proteins, free PSA has not. That’s why a free PSA test only measures unbound PSA in your bloodstream, whereas standard PSA test measures total PSA.

Men with prostate cancer generally have lower levels of free PSA than their counterparts without cancer.

A free PSA test is useful because it can decrease the need for unnecessary prostate biopsies. Plus, a free PSA test doesn’t cause complications that may occur due to a biopsy. 

Transrectal ultrasound (TRUS)

Transrectal ultrasound is an examination of the prostate via ultrasound. Healthcare professionals generally order transrectal ultrasounds after abnormal DRE and PSA tests. 

To perform the test, a doctor inserts a small probe into a patient’s rectum. The instrument relies on sound waves to send a picture to a computer screen. 

While TRUS can cause discomfort, it’s not as painful as a prostate biopsy. Like other tests, it doesn’t cause complications that occur after the biopsy procedure. 

It’s important not to confuse the TRUS test with TRUS-guided biopsy. Sometimes a doctor can perform a prostate biopsy using TRUS as an instrument to obtain the samples. 

MiPS

Mi Prostate Score urine test (MiPS) is a test that evaluates the risk of prostate cancer by looking at levels of markers such as PSA, PCA3, and TMPRSS2:ERG (T2:ERG). The test is ordered after abnormal results of DRE and PSA tests. 

Here, PCA3 stands for prostate cancer antigen 3, a gene that is overexpressed in prostate cancer cells. Basically, PCA3 is specific to cells of prostate cancer rather than prostate cells in general. That’s why the presence of this gene is a good indicator of prostate cancer. 

Also, T2:ERG is a result of translocation or fusion of parts of two different genes called TMPRSS2 and ERG. This fusion is present in almost half of advanced prostate cancers.

The advantage of MiPS is that it provides more thorough information than PSA alone. While this test alone can’t confirm a prostate cancer diagnosis, it shows a high possibility of prostate cancer. After all, it looks for the presence of genes that are mainly expressed in cancer patients. 

Our Natural & Non-Invasive Prostate Cancer Screening

In our opinion, a far safer and gentler prostate biopsy alternative is our Advanced Prostate Cancer Risk Assessment (APCRA). This consists of non-invasive blood tests and specialized color Doppler scans. 

The variety and sophistication of some of these new blood tests make this a very realistic alternative to a prostate biopsy, especially if you have a preference for non-invasive diagnostics and treatments. 

After this testing, you will receive a thorough, 3-hour consultation from a Naturopathic Physician who is also a Professor of Urology and a very detailed, written report of your results to be discussed during the appointment.

He will walk you through the results of his assessment and explain every aspect and each option available to you, while also answering any questions that you may have.  Your consultation will be like an educational mini-seminar about the real issues facing you as a patient.

Most urologists will have a preference for the particular treatment that they provide. However, the consultant you will see has no agenda and is completely free to offer honest, independent advice. 

He will try and help with any information you need in order to arrive at your decision. But he will not try to sway you one way or the other. 

Aside from that, the greatest additional benefits of the APCRA are that it is non-invasive, does no damage, and does not close off any avenues for future treatment.

To book our Advanced Prostate Cancer Risk Assessment, please call our customer service team on +1-888-868-3554 who will be happy to assist you and offer any further information.

Conclusion

Prostate biopsy is described as the only test to determine the presence of prostate cancer. Doctors and urologists often push for this procedure, but it’s not as harmless as they claim. 

A prostate biopsy has various side effects ranging from pain to bleeding and urinary problems. The test can also cause infection and nerve damage and aggravate your health problem. For that reason, it’s important to consult a doctor regarding alternatives to prostate biopsy.

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Find out about Our Natural & Non-Invasive Advanced Prostate Cancer Risk Assessment (APCRA).

Sources

  1. Klein T, Palisaar RJ, Holz A, Brock M, Noldus J, Hinkel A. The impact of prostate biopsy and periprostatic nerve block on erectile and voiding function: a prospective study. J Urol. 2010. https://pubmed.ncbi.nlm.nih.gov/20727540/ 
  2. Sooriakumaran P, Calaway A, Sagalovich D, Roy S, Srivastava A, Joneja J, Shevchuk M, Tewari AK. The impact of multiple biopsies on outcomes of nerve-sparing robotic-assisted radical prostatectomy. Int J Impot Res. 2012. https://pubmed.ncbi.nlm.nih.gov/22534563/ 
  3. Oesterling JE, Rice DC, Glenski WJ, Bergstralh EJ. Effect of cystoscopy, prostate biopsy, and transurethral resection of prostate on serum prostate-specific antigen concentration. Urology. 1993. https://pubmed.ncbi.nlm.nih.gov/7691013/

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3 Comments

  1. Quinn Braverman

    There is certainly a lot to know about this subject. I love all of the points you have made.

  2. Michael

    I have had 2 prostate biopsies 2 years apart. Transperineal. The most recent targeted/fusion MRI involved taking 42 cores! I experienced ED for over 8 weeks with quite dark brown blood in the semen. Admittedly some relatively low risk cancer was found. However I can’t agree with doctors who say this is a minimally invasive procedure, as the side effects are serious and should not be underestimated. All well and good if you eventually recover, however I do not see how it can possibly be the case that poking needles on such a scale into the gland can not be harmful – and the more so, the more times it happens. It seems common sense that it may aggravate any low level cancer that happens to be there and maybe – as mentioned above – seed it outside as the needles are withdrawn. I wonder if any studies have been carried out about this.

    • Ben's Natural Health Team

      Hi Michael,

      Thanks for your comment.

      We share your concern about the potential side effects, complications and spreading of cancer as a result of prostate biopsy. It’s not uncommon for issues with urination, bleeding, infection and sexual health to last weeks if not months after biopsy. If all of the above wasn’t reason enough to avoid biopsy then there is also the risk of seeding cancer via needle tracking. Some studies have shown the risk of this in other forms of needle biopsy used to detect cancer in the breast, liver or lung and these studies are available to read via PubMed.

      If you’d like more information on active surveillance once you’ve been diagnosed with low-level, non aggressive prostate cancer then please get in touch with our support team via phone or email.

      📧: [email protected]
      ☎️: 888 868 3554

      Wishing you good health,
      Ben’s Natural Health Team

 
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