Transrectal Ultrasound Guided Prostate Biopsy

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What is a transrectal ultrasound guided prostate biopsy?

A prostate biopsy is recommended as further investigation of an elevated PSA or an abnormality of the prostate on rectal examination. It is performed under ultrasound guidance.

Ultrasound uses sound waves to produce images. It is completely safe and there is no radiation. The sound waves are transmitted by the ultrasound probe (transducer). Please read this leaflet carefully as it provides important advice on preparation for the procedure.

Preparing for the procedure

We will provide you with instructions regarding all aspects of preparing for your operation.

  • Pre-operative blood and urine tests.
  • Details of admission to hospital.
  • Information regarding fasting and medications.

If your procedure is under Local anaesthetic

You do not need to fast before the biopsy. Two hours before the biopsy you need to take the antibiotics and use the enema.

Antibiotics: You should take the 2 ciprofloxacin tablets we have given you. Take either 30 minutes before food or 2 hours after food.

Enema: Your Urologist may give you specific instructions on use, otherwise proceed with the following instructions. Use the enema 2 hours before the procedure. Remove the tip from the enema. Insert into the rectum and squeeze contents of enema. The enema should work within half an hour.

If your procedure is under sedation/ General anaesthetic

Antibiotics: You should take the 2 ciprofloxacin tablets we have given you 2 hours prior to admission. Please take these only with a sip of water as you will be fasting for the procedure.

Enema: Your Urologist may give you specific instructions on use, otherwise proceed with the following instructions. Use the enema 2 hours prior to your admission. Remove the tip from the enema. Insert into the rectum and squeeze contents of enema. The enema should work within half an hour.

What to expect afterwards

It is usual to experience some bleeding from the urethra and from the rectum after the biopsy. This can last from 2 days to 2 weeks, but it usually settles within one week. You may also see blood in the semen which may last for several weeks, depending on how often you ejaculate. This is not dangerous. About 25% of men have some discomfort passing their urine afterwards but this usually settles quickly.

Complications

Infection

There is a small risk (1%) of developing an infection in the blood stream – septicaemia. This can cause you to feel unwell with fevers and chills. If this happens you should contact us. You may need admission to hospital for treatment with antibiotics through a drip. In the unlikely event this happens overnight you will need to go to a hospital emergency department.

Bleeding

You should expect to see some bleeding as mentioned above. If the urine is red then you should drink extra fluid to help keep the urine light in colour. If the bleeding seems excessive, either more than half a cup from the rectum or you are passing clots in the urine, then you should contact us. You may need admission to hospital.

Urinary Tract Infection

If you have burning when you pass your urine that does not seem to be getting better after 2 days then you could have a urine infection. Please contact us to organise a urine test and assessment.

After discharge from hospital

We suggest you rest quietly for the remainder of the day. Please avoid heavy lifting or straining until the blood clears from the urine and bowels. An appointment will be made to come back for the results.

Driving

You should not drive for at least 24 hours after having sedation/ general anaesthetic (or as instructed by your Urologist).

Patients who are travelling outside the metropolitan area are required to check when they are able to travel, and will be required to stay in the metropolitan area for 24 hours (or as         instructed by your Urologist).

Emergency Contacts

In the event of an emergency, call our office within business hours and speak to our Practice Nurse.  If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.

Ashford Hospital (8375 5205)

55 Anzac Highway, Ashford SA 5035

Emergency Department is open 7 days a week, 8:00am until 10:00pm

Wakefield Hospital (8405 3440)

300 Wakefield Street, Adelaide SA 5000

Emergency Department is open 7 days a week, 24 hours

**For patient’s outside the Metropolitan area, please present to your nearest hospital emergency department.

Follow up

A follow up appointment will be planned for you a few days following your procedure.

If you have any concerns after your procedure, please contact our office and speak to one of the practice nurses.

The content provided within this document is intended as a guide only and does not apply to all patients. Additional information, including patient specific potential risks, must be obtained during consultation with your Urologist.