Risks & complications of a prostate biopsy

Written by dr. tina m. st. john
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Risks & complications of a prostate biopsy
Prostate biopsy is typically an outpatient procedure (Black standing man over white (silhouette) image by Yura Pavlyuchkov from Fotolia.com)

A prostate biopsy involves taking small samples of prostate tissue for examination under the microscope to determine whether cancer cells are present in the gland. Most commonly, doctors utilise a transrectal ultrasonography-guided prostate biopsy procedure to collect tissue samples with a needle passed from the rectum into the prostate. Alternatively, samples may be collected through a flexible instrument inserted into the urethra--the tube through which urine passes to the outside of the body. Although most prostate biopsies are uneventful, complications are possible.

Acute prostatitis

Infection of the prostate gland, or prostatitis, is a risk of prostate biopsy. The rectum normally stores bacteria-laden faecal material until it is passed during a bowel movement. Although the preparation for a transrectal ultrasonography-guided prostate biopsy typically includes a cleansing enema before the procedure, residual fecal bacteria remain in the rectum. In an effort to prevent infection, antibiotics are typically administered shortly before a prostate biopsy and are continued for a few days after the procedure.

Despite precautionary efforts, bacteria may be introduced into the prostate during the biopsy procedure, causing acute prostatitis in some men, reports the University of Pittsburgh Medical Center in the U.S. Symptoms may include fever and chills, urinary urgency and frequency and difficulty passing urine. Spread of the infection to the bloodstream may cause a severe illness known as urosepsis, which is potentially life-threatening.

Rectal bleeding

Rectal bleeding may occur after a transrectal ultrasonography-guided prostate biopsy. In a 2004 research study published in the British Journal of Urology International, Dr. Khurshid Ghani and colleagues report that rectal bleeding occurred in 17 percent to 27 percent of study patients undergoing transrectal prostate biopsy, with the incidence of bleeding correlated to the number of biopsy samples taken during the procedure. One of 760 study patients experienced significant rectal bleeding requiring hospitalisation.

Bleeding of the genitourinary tract

Blood often appears in the urine for a few days after prostate biopsy. Small amounts of blood typically cause a pinkish appearance to the urine. In the Ghani study published in the British Journal of Urology International, researchers found 39 percent to 44 percent of patients experience blood in the urine after prostate biopsy. Heavy bleeding or persistent bleeding beyond two to three days after the procedure requires medical evaluation, says USC Norris Cancer Hospital in the U.S.

Small amounts of blood may also appear in the ejaculate after prostate biopsy. The Mayo in the U.S. reports that this side effect of prostate biopsy may persist for up to a month after the procedure.

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