{"id":23957,"date":"2020-11-11T20:50:00","date_gmt":"2020-11-11T20:50:00","guid":{"rendered":"https:\/\/www.bensnaturalhealth.com\/blog\/?p=23957"},"modified":"2022-09-12T10:32:44","modified_gmt":"2022-09-12T10:32:44","slug":"what-is-transperineal-prostate-biopsy","status":"publish","type":"post","link":"https:\/\/www.bensnaturalhealth.com\/blog\/prostate-health\/what-is-transperineal-prostate-biopsy\/","title":{"rendered":"What Is Transperineal Prostate Biopsy?"},"content":{"rendered":"

Prostate cancer is one of the most common types of cancer in the world. In the United States, one in nine men will develop this cancer at one point or another.<\/p>\n\n\n\n

Although a serious disease, it\u2019s possible to recover from prostate cancer. The key is to diagnose the condition in the early stages. For diagnosis purposes, doctors usually perform a transrectal biopsy.<\/p>\n\n\n\n

However, this research is flawed and fails to diagnose many cases. Transperineally performed prostate biopsy emerges as an effective solution for this problem and an accurate diagnostic test. Read on to learn more.<\/p>\n\n\n\n

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What is a transperineal biopsy?<\/h2>\n\n\n\n

The transperineal biopsy of the prostate is a type of guided prostate biopsy where the\u00a0urologist<\/a>\u00a0passes the biopsy needle through the perineal skin and into the almond-shaped gland. The perineum is the skin between the testicles and rectum.\u00a0<\/p>\n\n\n\n

The whole purpose of this approach is to improve the cancer detection rate.<\/p>\n\n\n\n

An ultrasound was placed in the\u00a0rectum guides biopsy needle. In fact, several approaches for transperineal prostate biopsy exist. The choice of the technique depends on whether a fusion or a systematic biopsy is necessary. It also depends on whether the patient is in the clinic under sedation.<\/p>\n\n\n\n

The first approach uses a stepper, a device that cradles the ultrasound probe and provides a guidance grid for the biopsy needle. The disadvantage of this approach is that each\u00a0biopsy<\/a>\u00a0requires a skin puncture. As a result, this technique\u2019s utility is limited in clinics where transperineal prostate is performed under local anesthesia only.\u00a0<\/p>\n\n\n\n

The freehand approach is yet another technique. The approach uses a needle access guide. Only one or two skin punctures are necessary for each side of the prostate.<\/p>\n\n\n\n

Since the needle access guide is positioned through the perineum\u2019s anesthetized skin, the urologist can reintroduce the biopsy needle for multiple biopsies. That way, new skin puncture for each biopsy is unnecessary. The\u00a0ultrasound probe<\/a>\u00a0in the rectum guides the biopsy needle. The freehand technique improves patient comfort.<\/p>\n\n\n\n

Transperineal fusion biopsy is considered safe, highly targeted, and relatively comfortable.<\/p>\n\n\n\n

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How does it differ from other types of biopsies?<\/h2>\n\n\n\n

A transperineal prostate biopsy is not the only biopsy that can diagnose prostate cancer. A transrectal prostate biopsy is the most common option.<\/p>\n\n\n\n

As you can conclude by its name, standard transrectal biopsy involves reaching the prostate through the rectum to obtain the sample. The transurethral method is also possible. In this case, the doctor uses a cystoscope (a flexible tube and viewing device) to obtain the sample through the urethra. There is also a saturation biopsy, which is performed in high-risk patients.<\/p>\n\n\n\n

The whole idea of biopsy may seem complicated, and it\u2019s useful to address it first. The doctor inserts a thin, hollow needle into the\u00a0prostate gland<\/a>. When they pull out the needle, it removes a small cylinder of prostate tissue called biopsy core. The techniques to obtain these samples vary and include the approaches mentioned above.<\/p>\n\n\n\n

Studies show that TP biopsy has the same diagnostic accuracy as a transrectal biopsy. However, TP targeted prostate biopsy is safer and more valuable. Compared to its counterpart, transperineal biopsy has a lower risk of infection and rectal bleeding. Scientists recommend doctors to perform TP biopsy whenever they can.<\/p>\n\n\n\n

Even though the transrectal technique is considered standard today, it has a higher risk of significant complications, including sepsis<\/a>. Also, some areas of the prostate, including the anterior prostate, are undersampled with transrectal biopsy (TR biopsy). This means that some clinically significant\u00a0prostate cancers<\/a>\u00a0are completely overlooked. A transperineal biopsy helps navigate around both these problems and improves prostate cancer detection.<\/p>\n\n\n\n

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Preparing for your biopsy<\/h2>\n\n\n\n

Your urologist will inform you about the targeted biopsy and the course of the procedure. Make sure to ask questions and express your concerns.\u00a0<\/p>\n\n\n\n

Before the biopsy, you should let the doctor know if you\u2019re taking some medications. This can help the doctor determine the best form of anesthesia but also to avoid potential complications.<\/p>\n\n\n\n

When you arrive at the doctor\u2019s office, hospital, or clinic, you will get a specimen pot for a\u00a0urine sample<\/a>. Before the biopsy can even start, the healthcare professional will check urine for the signs of infection. Should they find the presence of infection, they will need to postpone biopsy.\u00a0<\/p>\n\n\n\n

To prevent infection, you will get antibiotics 40 to 60 minutes before the surgery. This practice is called antibiotic prophylaxis. Then, you will need to change into a hospital gown so the biopsy can start.\u00a0<\/p>\n\n\n\n

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During the biopsy<\/h2>\n\n\n\n

Before the biopsy starts, you will need to lie on your back on the recliner chair and place your legs on the supportive stirrups. The healthcare professional may apply tape to move the scrotum out of the way and move supportive stirrups so that your knees are bent. The urologist then performs a\u00a0digital rectal exam<\/a>\u00a0to feel the prostate before inserting an ultrasound probe into the rectum. The transperineal ultrasound probe is covered with lubricating jelly to minimize discomfort.\u00a0<\/p>\n\n\n\n

Thanks to the ultrasound guidance, the urologist can see the prostate\u2019s image on the ultrasound screen. The imaging serves to guide the collection of the biopsy. Keep in mind that the ultrasound probe\u2019s insertion may be uncomfortable, but it doesn\u2019t hurt. It\u2019s also useful to mention that MRI (magnetic resonance imaging<\/a>) can guide the biopsy needle during the procedure.<\/p>\n\n\n\n

The healthcare professional cleans the perineum with an antiseptic solution. After that, a patient receives either local or general anesthesia. The choice of anesthesia depends on the doctor. The doctor bases this decision on your general health and symptoms you experience. Just like the doctor chooses whether to use MR imaging or ultrasound.<\/p>\n\n\n\n

When the anesthesia kicks in, the urologist inserts a guide tube into the perineum. They need to do it twice (to obtain a sample once from both the left and right side of the prostate). The biopsy needle goes through the guide tube to take those samples. As the biopsy is taken, you may hear a \u201cclick\u201d sound if you\u2019re under local anesthesia. This happens because a device featuring a spring-loaded needle takes the biopsy.<\/p>\n\n\n\n

A transperineal prostate biopsy usually takes 20 to 40 minutes.<\/p>\n\n\n\n

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After the biopsy<\/h2>\n\n\n\n

The transperineal prostate biopsy is an outpatient procedure. You can go home the same day. However, you have to be in the hospital for at least a few hours after general anesthesia. The patient goes home when fully recovers after waking up from anesthesia. That means after he eats, drinks something, and passes urine normally.\u00a0<\/p>\n\n\n\n

The medical team looking after you will ensure pain is under control before you\u2019re discharged. Waking up from general anesthesia may still make you drowsy. You shouldn\u2019t drive home. Drowsiness can increase the risk of accidents.\u00a0<\/p>\n\n\n\n

After the procedure, the medical team will give you an absorbent pad to put in your underwear. You\u2019ll need it due to the small amount of bleeding from the skin punctures and the\u00a0urethra<\/a>.\u00a0<\/p>\n\n\n\n

For the next couple of days, you will feel discomfort in the biopsy area. Discomfort is mild, so may just need to take the usual over-the-counter painkiller.\u00a0<\/p>\n\n\n\n

During the next 24 hours, it\u2019s important to drink plenty of water<\/a> or other non-alcoholic fluid.<\/p>\n\n\n\n

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Side effects<\/h2>\n\n\n\n

Generally speaking, a transperineal approach is a safe test. However, every test or procedure carries a certain risk of adverse reactions. The TP prostate biopsy is not the exception. Some of the most common side effects of this test include bleeding, pain, and infection. The risk of developing these problems is not high.<\/p>\n\n\n\n

For example, infection such as sepsis affects one in 500 men. About 1% of men experience\u00a0urinary retention<\/a>\u00a0requiring catheter placement. Less than 5% of men have temporary erectile dysfunction. These complications are possible but not so common.<\/p>\n\n\n\n

When it comes to common side effects, most men have blood in urine and semen alongside bruising of the skin. These adverse reactions are mild and tend to clear out within a few days.\u00a0<\/p>\n\n\n\n

The biggest advantage of transperineal biopsy is an absence of a common side effect linked with the transrectal approach. That side effect is rectal bleeding. In a transperineal biopsy, the needles don\u2019t go through the rectal wall. As a result, you don\u2019t experience this common yet uncomfortable\u00a0side effect<\/a>.\u00a0<\/p>\n\n\n\n

When it comes to infections after TP biopsy, you can prevent them by drinking plenty of water. You see, water flushes out the blood and thereby reduces the risk of infection. If you experience the symptoms of infection, you need to call your doctor right away or go to the emergency department. The signs and symptoms of infection include:<\/p>\n\n\n\n