Prostate biopsy

For confirmation of a prostate cancer, definition of a stage of its development carry out a prostate biopsy: select a prostate fragment for a further histologic and cytologic research.

Carry out a biopsy in three ways:

• under manual control, blindly. The patient is stacked on the right side, it draws in legs to a stomach. Anesthesia carry out local, using special gels-anesthetics. After that the doctor carefully enter a needle into a rectum, controlling at the same time its movement by a finger, and makes 4-6 punctures of a prostate. This diagnostic method is considered outdated and is applied because of insufficiency of control over holding a procedure more and more seldom.
• Polyfocal biopsy. It will be out under control of ultrasonography of the device. Fragments of a prostate take away from 12 points of body.
• Saturation biopsy. It is considered the most advanced and exact diagnostic method: material for the analysis undertakes from 24 points of a prostate. Thanks to this method cancer can be revealed at an early stage.

Indications to carrying out a biopsy of a prostate

Distinguish primary and secondary biopsies.

Primary biopsies of a prostate carry out at suspicion of cancer:

• at the increased level of prostatspetsifichesky antigen – there is more 4ng/ml;
• after identification by means of transrectal or transabdominal ultrasonography of a zone with low echogenicity in a prostate;
• after identification in a prostate of a node or consolidation;

Repeat a biopsy if the result of primary diagnosis was negative and in such cases:

• the increased level of prostatspetsifichesky antigen remains and grows;
• density of antigen makes more than 15%;
• ratio of free antigen to the general less than 10%;
• at primary biopsy the prostatic intraepithelial neoplasia of high degree was found;
• at the first research not enough material was taken.

Considering that a biopsy of a prostate of a maloboleznenn, practice only local anesthesia – use катеджель, gel of lidocaine and other similar drugs. Carrying out an intravenous anesthesia is allowed in rare instances since it can cause a complication.

It is possible to carry out a prostate biopsy only with the consent of the patient.

Preparation for a biopsy

Before carrying out a biopsy the patient undergoes various inspections: takes a blood test for the general analysis, I wet – for crops on flora and the general analysis. If the patient accepted anticoagulants, they should be cancelled one week prior to a biopsy: heparin, aspirin, Trombostopum, фраксипарин, Syncumarum and to make the test on a prothrombin index and time. If drugs cannot be cancelled, the biopsy of a prostate should be carried out in the conditions of a hospital.

On the eve of the procedure it is undesirable to have supper, in day of carrying out a biopsy the light breakfast is allowed. Besides on the eve of a biopsy in the evening and do a cleansing enema in the morning. If necessary and according to the medical recommendation the patient takes antibiotics for 24 h prior to a procedure and 3-4 more days after a biopsy.

Contraindications to carrying out a biopsy

The biopsy of a prostate cannot be carried out in the presence in a rectum of an acute inflammation, bleeding, fecal masses, acute prostatitis.

Prostate biopsy complications

In spite of the fact that the biopsy is carried out in the majority a case on an outpatient basis, in day of holding a procedure it is desirable to issue the sick-list.

After a biopsy of a prostate of a complication develop seldom: blood in Calais and urine, temperature increase, difficulties with an urination, an inflammation of testicles, appendages of testicles and a prostate, a loss of consciousness, a proctorrhagia, blood poisoning can be observed.

If complications because of a prostate biopsy nevertheless arose, it is necessary to see a doctor immediately.