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Discharge advice for patients undergoing Trans-Rectal Biopsy of Prostate

You have had or are going to have a trans-rectal biopsy of your prostate. This involves taking between five and eight tiny thread-like biopsies with the aid of an extremely fine, disposable biopsy needle. No anaesthesia is necessary. Biopsies are taken with the aid of an ultrasound scanner, via the rectum. The Consultant Radiologist performing the procedure is able to see the prostate on the screen on the ultrasound machine, whilst he is taking the biopsy.

Please note:
If you are taking warfarin, other anticoagulants or long term aspirin you should contact the
x-ray department prior to the procedure as these drugs will have to be stopped for a few days prior to the biopsy. The Consultant will advise you about this. Patients taking warfarin may need a blood test (to look at the blood clotting profile) 48-72 hours before the biopsy so that the result will be available before the biopsy. This blood test may be carried out at in the Outpatient Department at Springfield Hospital.

This procedure is performed to establish whether or not the prostate gland contains any cancerous cells. Your Consultant or GP may
have referred you to the x-ray department for one of the following reasons:

1. Your PSA blood result was higher than expected. PSA is a naturally occurring antigen contained in the blood of males which sometimes is raised if a cancer is present in the prostate. It may be raised for other reasons which are nothing to do with a cancer being present.

2. You may have already undergone an ultrasound of the prostate which showed some abnormal enlargement.

3. During digital examination, your Consultant or GP may have felt that your prostate was enlarged and required further investigation.

Following the biopsy, you may notice some small streaks of blood in your bowel movements. This is quite normal and nothing to worry about. If however the bleeding becomes excessive, or you are at all worried, please contact either your GP or the Springfield Hospital immediately as very occasionally you may need some treatment to stop this bleeding. You may notice that your urine becomes bloodstained. You may pass small blood clots occasionally in your urine. You may also notice that your semen becomes bloodstained or pink. Again, this is nothing to worry about, and should settle down on its own accord over the next 6-8 weeks.

One of the problems of taking a biopsy through the rectum is the risk of infection. The Consultant Radiologist will have ensured that you were given either an intravenous antibiotic injection prior to the procedure or some oral antibiotics prior to and following the procedure.

At times, both of these methods may be used together.

It is important that if you have been given some antibiotics to take following the procedure, that you complete the course. These preventative methods should stop any infection occurring, If, however, within a day of having this biopsy you experience a rise in your body temperature, shivering, severe headache or flu-like
symptoms, again please contact your GP or the Springfield Hospital immediately.

The tiny biopsies that have been taken will be sent to the laboratory to be looked at under a microscope by a Pathologist. The results of this biopsy will take approximately four to seven days to be returned to Consultant or GP. It is therefore important to arrange a follow up appointment for approximately 7-10 days time. You will be advised regarding this at the time of the procedure.

You may continue with your normal daily activities including driving, sports etc. immediately or once you feel well enough to do so. You may experience some pain or discomfort in the perineal area (the area between the scrotum and back passage). A mild analgesic that you would normally take for pain should be sufficient to ease this.

If you have any concerns please contact Springfield Hospital on 01245 234080 and ask to speak to the Senior Nurse on duty and she will be happy to help you.

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