On this pageIs safhay par
Yeh kya hai aur kyun kiya jata hai
PSA ka barhna, muaine mein prostate ka gair-mamooli lagna, ya MRI scan mein shak wali jagah akele cancer sabit nahi kar sakte. Biopsy woh test hai jo yeh kar sakta hai. Aik patli khokhli sui se prostate ke chhote tukre, aam tor par kayi jagahon se, liye jate hain aur pathologist unhein khurdbeen se dekhta hai (dekhein PSA test ki guide, prostate ke MRI ki guide aur TRUS ki guide).
Prostate tak pohanchne ke do bunyadi tareeqe hain. Transperineal biopsy mein sui pastoon aur maqad ke darmiyan ki jild (perineum) se guzarti hai. Transrectal biopsy mein woh rectum ki deewar se guzarti hai. Dono mein rectum mein rakhi ultrasound probe sui ki rehnumai karti hai. Agar MRI scan mein shak wali jagah nazar aayi ho to biopsy us par nishana laga kar li ja sakti hai, aur doosri jagahon se bhi sample liye ja sakte hain.
Transperineal tareeqa ab zyada istemal ho raha hai kyunke is mein infection ka imkaan kam hota hai. Aap ko kaun sa tareeqa diya jayega yeh dastiyabi aur aap ke urologist ke mashwaray par munhasir hai.
Procedure se pehle
- Pehle peshab ka test hota hai. Biopsy se pehle peshab ke infection ka ilaaj zaroori hai (dekhein peshab ke tests ki guide).
- Antibiotic ka cover: infection ka imkaan kam karne ke liye aap ko antibiotics di ja sakti hain. Kisi bhi allergy ke baare mein team ko batayein.
- Khoon patla karne wali dawayein: kisi bhi khoon patla karne wali dawa ke baare mein team ko batayein. Apne taur par koi dawa band na karein. Aap ka urologist batayega ke kya karna hai.
- Aant ki safai: transrectal biopsy ke liye aap se kaha ja sakta hai ke neeche ke aant ko khaali karne ke liye enema ya isi tarah ka tareeqa istemal karein. Jo hidayaat milein un par amal karein.
- Anaesthetic: transperineal biopsy local anaesthetic (sunn karne ke injection), sedation ya poori bay-hoshi mein ho sakti hai. Transrectal biopsy aksar sunn karne wali gel ya injection ke saath hoti hai. Team batayegi ke aap ko kya diya jayega.
- Aap se razamandi (consent) maangi jayegi. Khatrat ke baare mein, aur yeh ke nateeja kab aur kaise milega, poochhne ka yehi waqt hai.
- PSA ke nateeje aur MRI ki report saath layein. Qeemat aur yeh kahan hogi, yeh bhi poochh lein.
Procedure ke dauran
Tareeqe ke mutabiq aap karwat par ya peeth ke bal tangon ko uthaye hue lette hain. Jagah saaf ki jati hai aur sunn ki jati hai. Prostate ko screen par dikhane ke liye rectum mein aik patli ultrasound probe rakhi jati hai.
Phir sui ko prostate tak le jaya jata hai aur chhote samplon ki aik silsila liya jata hai. Har sample lete waqt click ki awaaz aati hai, aur dabao ya chhoti si tez chubhan mehsoos ho sakti hai. Aam tor par kam az kam bees ke qareeb, ya zyada, sample muktalif jagahon se liye jate hain.
Procedure aam tor par pandrah se tees minute leta hai. Zyadatar log usi din ghar chale jate hain.
Procedure ke baad
- Peshab mein khoon chand din tak aam hai. Bohat paani peeyein, siwaye is ke ke aap se kam karne ko kaha gaya ho.
- Manyi mein khoon aam hai aur kayi haftay tak reh sakta hai. Yeh dar paida karta hai lekin nuqsandeh nahi.
- Pakhane mein khoon transrectal biopsy ke baad chand din ho sakta hai.
- Jagah par dard ya dukhan chand din tak. Aam dard kam karne wali dawayein madad karti hain.
- Sargarmi: aik do din aaram karein, aur chand din bhaari wazan uthane aur zor wali kasrat se parhez karein. Jinsi taluq aur gaari ke baare mein team se poochh lein.
Mumkina khatrat
- Aam: peshab, manyi ya pakhane mein khoon, aur dukhan.
- Kam aam: peshab ka infection, thori der ke liye peshab na kar paana (bari prostate mein zyada imkaan), aur takleef jis ke liye dard ki dawa chahiye.
- Bohat kam: khoon mein phailne wala shadeed infection jis ke liye fauri hospital ilaaj chahiye, zyada khoon behna, aur khaas hissay ki sakhti mein aarzi masla.
Shadeed infection bohat kam hota hai lekin khatarnak ho sakta hai. Agar biopsy ke baad ke dinon mein bukhar, kapkapi ho ya aap bohat bimar mehsoos karein to fauran madad lein.
Aap ke nateeje
Nateeja aam tor par aik se do haftay mein aata hai. Poochh lein ke nateeja kab aur kaise bataya jayega, aur yaqeeni banayein ke aap ko mile. Is par bharosa na karein ke woh khud bhej diya jayega.
- Cancer nahi mila. Yeh tasalli ki baat hai, lekin biopsy chhote cancer ko chhoot bhi sakti hai. Aap ka urologist batayega ke mazeed tests, PSA ki dobara jaanch ya MRI ki zaroorat hai ya nahi.
- Cancer mila. Report batati hai ke cancer kitna hai aur kitna aggressive nazar aata hai, aksar "grade group" ki shakal mein. Aap ka urologist is ka matlab samjhayega aur aap ke options par baat karega (dekhein prostate cancer ki guide).
- Doosri cheezein, jaise sozish ya aise cells jo cancer nahi lekin ghair-mamooli lagte hain, un ki follow-up ki zaroorat ho sakti hai. Aap ka urologist samjhayega.
Fauran madad kab lein
Agar in mein se koi bhi ho to fauran qareebi hospital ke emergency department jayein, ya us unit se raabta karein jis ne biopsy ki:
- Aap peshab nahi kar pa rahe, ya catheter se peshab nahi aa raha ya woh band ho gaya hai (dekhein urinary retention guide).
- Bukhar, kapkapi ya bohat bimar mehsoos karna (dekhein urinary tract infection guide).
- Zyada khoon behna, gehra surkh peshab ya lothray jo peshab rok dein.
- Shadeed dard jo aam dard kam karne wali dawaon se kam na ho.
Chand din gulabi peshab, kayi haftay manyi mein khoon, aur dukhan aam baat hai aur emergency ki zaroorat nahi.
Aam sawalaat
Kya is mein dard hota hai?
Sunn karne ke injection, sedation ya poori bay-hoshi ke saath zyadatar log ise takleefdeh lekin dard-rahit kehte hain. Har sample lete waqt dabao aur tez chubhan mehsoos hogi.
Kya biopsy karwana mehfooz hai?
Haan, yeh aam test hai aur shadeed masail bohat kam hote hain. Sab se ahem khatra infection ka hai, is liye bukhar ya bohat bimar mehsoos karne par fauran madad lein.
Mujhe MRI bhi kyun chahiye?
MRI scan shak wali jagahein dikha sakta hai taake biopsy un par nishana laga kar ho, aur woh jagahein bhi dikha sakta hai jin ki biopsy ki zaroorat nahi (dekhein prostate ke MRI ki guide).
Manyi mein khoon kitni der rahega?
Aksar kayi haftay, aur kabhi zyada. Yeh nuqsandeh nahi.
Agar biopsy mein cancer na nikle to?
Yeh achi khabar hai, lekin aap ka urologist phir bhi PSA ki dobara jaanch, ya doosra scan ya biopsy tajveez kar sakta hai, kyunke biopsy chhote cancer ko chhoot sakti hai.
Kya kaam par wapas ja sakta hoon?
Bohat se log agle din halke kaam par wapas aa jate hain. Chand din bhaari wazan uthane se parhez karein. Team se poochh lein.
What it is and why it is done
A raised PSA, an abnormal feel of the prostate on examination, or a suspicious area on an MRI scan cannot by themselves prove cancer. A biopsy is the test that does. A thin, hollow needle takes small cores of prostate tissue, usually from several areas, and a pathologist examines them under a microscope (see the PSA test guide, the MRI of the prostate guide and the TRUS guide).
There are two main ways to reach the prostate. In a transperineal biopsy the needle goes through the skin between the scrotum and the anus (the perineum). In a transrectal biopsy it goes through the wall of the rectum. An ultrasound probe in the rectum guides the needle in both. If an MRI scan showed a suspicious area, the biopsy can be aimed at it, as well as taking samples from other areas.
The transperineal route is increasingly used because it carries a lower chance of infection. Which route you are offered depends on what is available and what your urologist advises.
Before the procedure
- A urine test is done first. A urine infection must be treated before a biopsy (see the urine tests guide).
- Antibiotic cover: you may be given antibiotics to lower the chance of infection. Tell the team about any allergies.
- Blood thinners: tell the team about any blood-thinning medicine. Please do not stop any medicine on your own. Your urologist will tell you what to do.
- Bowel preparation: for a transrectal biopsy you may be asked to use an enema or similar to empty the lower bowel. Follow the instructions you are given.
- Anaesthetic: a transperineal biopsy may be done under local anaesthetic (numbing injections), sedation or a general anaesthetic. A transrectal biopsy is often done with local anaesthetic gel or injection. The team will explain what you will have.
- You will be asked for consent. This is the time to ask about the risks, and about how and when you will get the result.
- Bring your PSA results and any MRI report. Ask about the cost and where it will be done.
During the procedure
You lie on your side or on your back with your legs raised, depending on the route. The area is cleaned and numbed. A thin ultrasound probe is placed in the rectum to show the prostate on a screen.
The needle is then guided to the prostate, and a series of small samples is taken. You will hear a clicking sound each time a sample is taken, and may feel a pressure or a short sharp sting. Usually around a dozen or more samples are taken, from different areas.
The procedure usually takes around fifteen to thirty minutes. Most people go home the same day.
After the procedure
- Blood in the urine for a few days is common. Drink plenty of water unless told otherwise.
- Blood in the semen is common and can last for several weeks. It looks alarming but is harmless.
- Blood in the stool can happen for a few days after a transrectal biopsy.
- Soreness or aching in the area for a few days. Simple pain relief helps.
- Activity: take it easy for a day or two, and avoid heavy lifting and strenuous exercise for a few days. Ask the team about sex and driving.
Possible risks
- Common: blood in the urine, semen or stool, and soreness.
- Less common: a urine infection, being unable to pass urine for a short time (more likely with a large prostate), and discomfort that needs pain relief.
- Rare: a serious infection that spreads into the blood, which needs urgent hospital treatment, heavy bleeding, and a temporary problem with erections.
Serious infection is rare but can be dangerous. If you develop a fever, shivering or feel very unwell in the days after a biopsy, please seek urgent help straight away.
Your results
The result usually takes about one to two weeks. Ask when and how you will be told, and make sure you receive it. Do not rely on it being sent automatically.
- No cancer found. This is reassuring, but a biopsy can miss a small cancer. Your urologist will explain whether more tests, repeat PSA checks or an MRI are advised.
- Cancer found. The report describes how much cancer there is and how aggressive it looks, often as a "grade group". Your urologist will explain what this means and discuss your options (see the prostate cancer guide).
- Other findings, such as inflammation or abnormal-looking cells that are not cancer, may need follow-up. Your urologist will explain.
When to seek urgent help
Please go to the nearest hospital emergency department, or contact the unit that did your biopsy, if any of these happen:
- You cannot pass urine, or the catheter is not draining or has blocked (see the urinary retention guide).
- Fever, shivering or feeling very unwell (see the urinary tract infection guide).
- Heavy bleeding, bright red urine or clots that block the flow of urine.
- Severe pain that usual pain relief does not settle.
A few days of pink urine, blood in the semen for weeks, and soreness are expected and do not need an emergency visit.
Common questions
Does it hurt?
With numbing injections, sedation or a general anaesthetic most people find it uncomfortable rather than painful. You will feel pressure and a sharp sting as each sample is taken.
Is it safe to have the biopsy?
Yes, it is a common test and serious problems are rare. The most important risk is infection, so seek urgent help for fever or feeling very unwell.
Why do I need an MRI as well?
An MRI scan can show suspicious areas so the biopsy can be aimed at them, and can show areas that need no biopsy (see the MRI of the prostate guide).
How long will the blood in my semen last?
Often for several weeks, and sometimes longer. It is harmless.
What if the biopsy shows no cancer?
That is good news, but your urologist may still advise repeat PSA checks, or another scan or biopsy, because a biopsy can miss a small cancer.
Can I go back to work?
Many people return to light work the next day. Avoid heavy lifting for a few days. Ask the team.