Transrectal ultrasound-guided (TRUS) biopsy involves taking multiple samples of the prostate. The procedure is usually performed under light sedation with the patient lying on their side. An ultrasound probe is inserted into the rectum and used to guide up to 14 needle biopsies. These samples are then sent to a pathologist to examine under a microscope, with results available after a few days. The procedure takes about ten minutes.
Before Your Biopsy
Certain medications increase the risk of bleeding and need to be stopped prior to surgery. You should tell your surgeon about all prescription medicines, over the counter medicines, vitamins, and herbal supplements that you are taking. Some patients, such as those with artificial heart valves or high blood clotting risk, will need to take blood-thinning injections whilst coming off their tablet medications.
After Your Biopsy
If you have had sedation then a friend or family member will need to drive you home.
It is normal to pass urine frequently for a few days after the procedure.
It is normal to see some blood in the urine, faeces or semen for up to 2 weeks. Your semen may appear “rusty” for up to twelve weeks after the biopsy due to the presence of small amounts of blood.
Do not engage in any sexual activity for 3 days after your procedure. For the 5 days after your procedure, do not engage in sports, work out in a gym, ride a bicycle, or lift any objects heavier than 5 kg.
Specific Risks and Side Effects of TRUS Biopsy
- Urine infection is uncommon since antibiotics are given prior to the procedure.
- Excessive bleeding is rare after TRUS biopsy. If this occurs then you will be admitted to hospital for further management.
- TRUS biopsy carries with a 2-4% risk of septicemia. This is a severe infection in the blood which requires admission to hospital for intravenous antibiotics. It can occur even though antibiotics are routinely given.
When to contact your surgeon
- If you experience fevers, sweats, shakes, nausea or vomiting after you go home, or if you feel generally unwell.
- If you are unable to pass urine after the procedure.
- If urinary symptoms fail to settle after a few days, or if you develop burning pain whilst passing urine.
- If bleeding is severe or clots are present in the urine.