West Coast Urology  –  Geelong   |   Hamilton    |   Colac   |   Winchelsea

A. PROF RICHARD GRILLS

DR KATHRYN MCLEOD

MR PATRICK PREECE

Urological Surgeons

Prostate Biopsy (Transperineal)

To download a PDF document about ‘transperineal prostate biopsy’ please click:

  • A prostate biopsy involves taking tissue samples from the prostate gland and sending them to a pathologist for examination and analysis.
  • A ‘transperineal ultrasound guided’ prostate biopsy makes use of an ultrasound probe to ensure the correct parts of the prostate are being sampled.


A prostate biopsy allows your Urologist to determine whether any of the cells in your prostate gland have become cancerous. This is helpful when:

  • Your PSA (a chemical released by the prostate) shows a reading higher than normal levels.
  • You have a rapidly increasing PSA level.
  • Your prostate feels firm or irregular on rectal examination.
  • You have an abnormal MRI of the prostate.

A transperineal prostate biopsy is performed in hospital as day surgery under general anaesthesia.

Guided by an ultrasound probe which is placed in your rectum (back passage) your Urologist will pass a needle through your perineum, the area of skin between your scrotum and anus to take tissue samples of your prostate. These samples are taken in a grid like pattern to ensure different areas of your prostate are sampled. Generally around 20 separate tissue samples are taken however often more may be necessary. If you have undergone an MRI prior to your biopsy and any abnormal areas are identified, extra biopsies maybe taken from these areas also.

The reception staff at West Coast Urology will book a date for your biopsy. This is written at the front of this information booklet. You will be given an admission form to complete and return to St John of God Hospital – the hospital where your biopsy is booked. Please return the forms as soon as possible in person to the hospital’s front reception or send it in the mail at least one week before your procedure.

Cost

  • When you are booked in for your procedure you will be given an Informed Financial Consent (IFC) document which estimates how much you will be out-of-pocket for your procedure.
  • If you have private health insurance, there will be a ‘gap payment’ for the procedure. This will be an out-of-pocket expense payable by you.
  • You are required to pay the account in full then claim back from your health fund and Medicare. Please ask our reception staff to explain the process for your particular health fund. There will be additional costs for the anaesthetist; our staff will able to explain this to you.
  • If you do not have private health insurance, you will be required to pay the full amount of the account prior to your procedure. Following your procedure West Coast Urology will send you a receipt. You will then be able to take your receipt in to Medicare and claim a rebate. There will be additional costs for the anaesthetist, theatre fees and hospital stay; our staff will able to explain this to you.


Medications

 Please let your Urologist know if you are taking any blood thinning medication such as:

  • Warfarin (Coumadin)
  • Dabigatran (Pradaxa)
  • Apixiban (Eliquis)
  • Rivaroxaban (Xeralto)
  • Clopidogrel (Plavix, Iscover, CoPlavix)
  • Ticagrelor (Brilanta)
  • Dipyridamole (Asasantin)
  • Aspirin


Under special instructions given to you by your Urologist you may be asked to stop these medications before your procedure. If you are not sure or have not been given instructions, please call the rooms and speak to one of our Specialist Urology Nurses.

If you have been advised to stop your blood thinning medication your Urologist will advise you prior to being discharged home from hospital when you may restart your medication.

 
Please let your Urologist know if you are taking any of the following diabetic medications as you will need to cease them before your procedure:

  • Dapagliflozin (Forxiga, Qtern, Xigduo XR)
  • Empaglifozin (Jardiance, Jardiamet, Glyxambi)
  • Ozempic

 

 Day before your procedure

The hospital will contact you with your admission details and fasting instructions.

Fasting and medications

You need to follow the fasting instructions given to you by the hospital’s pre-admissions team.

Unless you have received special instructions otherwise, please continue to take all your other prescribed medications with a small sip of water. This includes diabetic medications (except those mentioned above).

 The biopsy

When you arrive at the pre-admissions area of the hospital, the staff will check your paperwork and details in order to complete your admission.

You will be asked to change into a hospital gown and an enema will be administered to you by one of the nursing staff before your procedure and before you are wheeled on a trolley into the operating room.

The anaesthetist will see you and discuss your General Anaesthetic. An intravenous line will be inserted into your arm or the back of your hand in order to administer your anaesthetic medication.

The procedure takes around 45 minutes. During this time your anaesthetist will administer antibiotics through your intravenous line, this is will reduce the risk of infection associated with this procedure.

After the procedure you will be taken to the recovery room. Once you have been able to pass urine without difficulty and you have recovered from the anaesthetic you will be discharged home.


Please ensure:

  • you have a responsible adult to drive you home. You are NOT to drive yourself home.
  • you have a responsible adult to stay with you overnight following your procedure. You must NOT stay alone.

You will be given a discharge instruction sheet to take home – please read this carefully.

  • Expect to have a small amount of bleeding where the biopsy needle has entered the skin in your perineum. A pad will be placed in your underpants to protect your clothing.

  • You may notice some blood in your urine for 1-2 weeks after the biopsy. Blood may also be noticeable in your semen when you ejaculate, this can take anywhere between 3-4 weeks to clear.

  • On rare occasions you may experience difficulty passing urine. In this instance, a catheter may need to be inserted to assist with draining the urine from your bladder. Generally, the catheter will stay in for 5-7 days to allow the inflammation in your prostate to settle. Once your catheter is removed, you will likely return to passing urine naturally.

 

Your Urologist will contact you by telephone with your results of your biopsy as soon as they are available (usually within 3 days) and a review appointment made as required.