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The prostate galnd is subjected to many diseases. The most common and hence most important are the chronic infection of the gland which appears in joung age and the cancer of the prostate which affects it in old age. Both may lead to a hardness in the gland. The rare formation of stones in the prostate may also give the feeling of hardness. It is important to verify any hard nodule in the prostate to exclude or diagnose its cancer.
The prostate specific antigen (PSA) is high in conjunction with cancer, But it may be also high in its absence. This is why we should to biopsy the gland whenever the PSA is high.
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Transrektaler ultrasound of the prostate
a = glands as a white line
b = evenly glandular content
Prostate Anatomy
a = bladder / b = bladder neck
c = right prostate lobe / d = left prostatic lobe
s = seed hill / f = urethra
g = capsule of the prostate gland / h = nerves and blood vessels of the prostate
i = adductor
Prostate Cancer
1 = area of cancer is confined to the capsule (early)
2 = cancer area extends from the capsule out (Adv)
3 = area of cancer spread in the gland (incidental finding)
Who qualifies for the operation?
Mostly old patients or men who have a hard nodule in the capsule of the gland detected during the urological rectal examination. Thís hardness may be examined by ultrasonography to be a little bit black in colour that is to say reflects little of the waves of ultrasonography.
How does the operation function?
The patient lyes on his back with his legs elevated, supported and opened. The prostate is examined through the rectum per finger and per ultrasonography. The prostate and its surrounding are infilterated with local anaesthesia. The ultrasonography guided needle is inserted under vision inside the prostate and a biopsy is taken using the special Biopsy gun.
Six biopsies are taken according to a special plan. A dressing is put between the legs.
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Transrectal biopsy of the prostate
a = the needle has penetrated into Prostatainnere a sample taken under ultrasound control
Frequently asked questions:
- Does every hardness in the prostate indicate cancer?
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No, this may be caused by a stone or by hardness in the tissues due to a long lasting infection of the gland (chronic prostatitis).
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- Can the urologist verify the differences between each hardness through the rectal digital examination?
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Yes, but in some cases it is difficult to do so.
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- Is the procedure painfull?
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No, it is not. It is done under local anaesthesia.
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- Why is it important to biopsy the prostate?
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This is to exclude cancer or establish the exact classification of the cells causing cancer. This reflects the agressiveniss of the disease.
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- Are there complications expected from the procedure?
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Sometimes you may experience a pic during the taking of the biopsa, bleeding from the urethra is the most common observation, bujt this stops in a few hours. Infection may happen which is prevented prophylactically with antibiotics.
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- How should I behave after the biopsy?
It is important to drink enough water. Pleas ehave a rest for a day and alarm your urologist when you have pain, fever, rigor or headache.
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- What should I do when there is blood in the stool?
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This is a rare happening. When you observe it, please eat light meals and keep your hygiene to optimum. It takes only one or two days to stop.
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