Rigi10™ Malleable Penile Prosthesis
Also Known As
Prostate needle biopsy, TRUS-guided prostate biopsy, Transrectal ultrasound-guided prostate biopsy, Transperineal prostate biopsy, MRI-TRUS fusion biopsy, Targeted prostate biopsy, Systematic prostate biopsy, Core needle biopsy of the prostate
Definition
A prostate biopsy is a diagnostic procedure in which small tissue samples are removed from the prostate gland using a specialized needle and then examined under a microscope to detect the presence of cancer or other abnormal cells.1 The prostate gland, found only in males, sits below the bladder and wraps around the urethra, and helps produce semen.2 The biopsy is considered the gold standard diagnostic technique for the detection of prostate cancer.3 It is typically performed using one of two main approaches: the transrectal method (through the rectum) or the transperineal method (through the skin between the scrotum and rectum).4 Ultrasound imaging is commonly used to visualize the prostate and guide the biopsy needle to ensure accurate sampling.5
Clinical Context
Prostate biopsy is primarily indicated when there is clinical suspicion of prostate cancer.1 The decision to proceed with a biopsy is complex and should be made on an individualized basis, considering several factors.3 The main indications include:
- Abnormal Digital Rectal Examination (DRE): When a healthcare provider detects nodularity, asymmetry, or diffuse firmness during a physical examination.1
- Elevated Prostate-Specific Antigen (PSA): Men with PSA values greater than 4 ng/ml with a normal DRE have a 30-35% risk of having cancer.1 However, cancer risk exists at any PSA level, and the decision should consider PSA density, free and total values, as well as patient-specific risk factors such as age and family history.3
- Suspicious Findings on Imaging: Particularly lesions identified on multiparametric MRI (mpMRI) with Prostate Imaging Reporting and Data System 2 (PI-RADS2) scores of 4 or 5, which indicate a high or very high likelihood of clinically significant cancer.1
The procedure is typically performed as an outpatient procedure and may involve local anesthesia, sedation, or general anesthesia depending on the approach and patient factors.4 For the transrectal approach, an ultrasound probe is inserted into the rectum to visualize the prostate, and a spring-loaded biopsy needle is used to collect multiple tissue samples.2 For the transperineal approach, the needle is inserted through the skin between the scrotum and rectum.4
Recovery after the procedure generally involves minimal restrictions, though patients may experience temporary side effects including blood in the urine, stool, or semen, mild pain or discomfort, and rarely infection or difficulty urinating.5 These symptoms typically resolve within a few days to weeks.3
The biopsy results, examined by a pathologist, help determine the presence of cancer, its grade (Gleason score), and extent, which guide treatment decisions.3 Negative results may still warrant continued monitoring with regular PSA testing, while positive results will lead to further evaluation and treatment planning based on the cancer’s characteristics.5