TRUS of the Prostate and Biopsy

  • Reference Number: HEY-121/2017
  • Departments: Radiology

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the health care team caring for you.

What is a TRUS of the Prostate and Biopsy?

You have probably been troubled by some symptoms or shown a raised prostate specific antigen (PSA) following a blood test. Following discussion with your doctor he has advised that you undergo a TRUS and biopsy of the prostate.  TRUS stands for Trans Rectal UltraSound.

A biopsy is the taking of a tissue sample, in this case several tissue samples of the prostate. The tissue samples will help your doctor with diagnosis of your prostate condition.

The procedure – what will happen?

  • Do not drink alcohol 24 hours prior to or 48 hours after the procedure.
  • If you are on warfarin or clopidogrel medication, please inform the department.
  • Inform the person performing the procedure if you have a latex allergy.

Please report to the Radiology Department (X-ray) reception at entrance 2 Castle Hill Hospital.  You will be directed to the Ultrasound Department where a member of staff, either a nurse or clinical support worker, will take care of you.  The procedure will be performed by a sonographer or a radiologist. You will be given a local anaesthetic during the procedure; this is usually Lidocaine 1%.

You could be in the Ultrasound Department for up to 3.5 hours as there is some preparation and recovery time required before and after your procedure. You are more than welcome to bring someone with you whilst you wait. However, they will not be able to accompany you into the procedure room.

A Radiology department nurse will place an intravenous cannula in your arm to enable the administration of prophylactic antibiotics in liquid form and oral antibiotics. The antibiotics will be given to and during the procedure.  The sonographer or radiologist performing the biopsy will explain the procedure to you and answer any questions you may have. You will then be asked to give written consent.

During the procedure you will be accompanied by a health care worker throughout.  You will be asked to lie on your left side and the sonographer / radiologist will put a small specially designed ultrasound probe into your back passage; this will allow the sonographer to see your prostate image in real time on the ultrasound machine monitor. Once the sonographer / radiologist has looked at the prostate he/she will inject some local anaesthetic under ultrasound guidance into the prostate to ensure that the procedure is more comfortable for you.

The sonographer /radiologist will then advance the biopsy needle through a probe guide, under ultrasound guidance, into the prostate to take a sample. This will be repeated a number of times in both the right and left sides of the prostate.  It will be necessary to take a minimum of 10 samples and you will be able to hear the biopsies being taken.  You should not feel any discomfort during the procedure, however, if you do, please let the sonographer / radiologist know.  Once the procedure has been completed you can get dressed again and you will be asked to sit in the waiting room.

What are the possible complications?

Post procedure complications can include some rectal bleeding, blood in the urine (haematuria), urinary retention and infection.

Post-operative pain management: After the procedure you should not feel unwell but any discomfort can be relieved by taking the recommended dose of pain relief tablets.

What happens afterwards?

Following the procedure you will be given a drink and a biscuit and asked to remain in the department until you have passed urine. This procedure can sometimes cause swelling of the prostate and we prefer that you stay in the department until we are sure you can pass urine normally.  It is not uncommon for there to be some blood present in the urine following this procedure and your sample will be checked by a clinical healthcare worker to make sure that if there has been any bleeding it is not excessive. Once your sample has been checked and found to be satisfactory, the clinical healthcare worker will remove your cannula and you will be allowed to go home.

There is a small risk of developing a serious infection. This would normally happen within 5 days following the procedure. Once you have left the hospital, if you develop a fever, feel hot and sweaty or experience pain in the lower back passage you should immediately contact Ward 15, Castle Hill Hospital on telephone number (01482) 623015 and speak to the Senior Urology House Officer.  He/she will deal with the problem. In the majority of cases none of these problems arise.

The biopsy results will be sent to your referring Urologist. This will take three weeks.

Please avoid alcohol 24 hours prior to and 48 hours following your procedure.  It is advisable if you are coming to the hospital in your own vehicle to be accompanied by someone who can drive you home.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Ultrasound Department on telephone number: ( 01482) 624044.

General Advice

Please read the information leaflet.  Share the information it contains with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this examination.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.