Ultrasound-guided prostatic needle biopsy
When is this exam indicated?
Patients with a previous diagnosis of prostate neoplasia in active surveillance or patients with clinical suspicion of neoplasia due to changes in PSA levels, abnormalities detected during ultrasound examinations or on the recommendation of a physician who has detected abnormalities on rectal examination.
How is it performed?
Prostate biopsy is performed using images from an endorectal ultrasound probe as a guide. The biopsy can be performed using an endorectal route (transrectal biopsies) or a direct access through the skin of the perineum, the area located between the rectum and the scrotum (transperineal biopsies). All tissue collected is sent to the pathological anatomy laboratories for histological analysis. The number of samples to be taken will be defined based on the anamnestic, clinical and biochemical data (usually varying between 12 and 24 prostate samples taken with a random sextant technique), optimizing the number of samples to obtain a valid sampling, limiting the risk of potential adverse events. Prostate biopsy is an outpatient procedure and does not require hospitalization. For some patients, due to the presence of a particularly low pain threshold or the presence of severe cardiovascular disease, anesthesiological care may be recommended. In the latter case, receiving anesthesiological assistance and performing the procedure under sedation, hospitalization and/or Day Surgery is required.
In case of ongoing anticoagulant/antiaggregant therapy or coagulopathies there could be an increased risk of bleeding related to the procedure. Therefore, appropriate measures shall be taken to limit the risk.