Template Guided Prostate Biopsies
What is the difference
between a TRUS and Biopsy and a Template Guided Biopsy using
A TRUS and Biopsy refers to a Trans rectal ultra sound and Trans rectal
biopsy of the prostate, in which 6-14 biopsy samples are taken of the
prostate in a non-specific pattern. This is performed under a local anaesthetic.
A template guided biopsy is carried out under
a general anaesthetic. After the anaesthetic has been administered,
an ultra sound probe is gently inserted into the back passage
and the prostate gland is scanned. A soft, flexible tube (catheter)
is inserted through the water pipe (urethra) and into the bladder
to drain the bladder. This is left in place for 6 hours after
the procedure. Using a grid (template), which has holes spaced
5mm apart, placed against the perineum, a biopsy needle is
inserted through each hole and the prostate is sampled every
5mm. Each biopsy taken is placed in a separate pot for the
Consultant Histopathologist to examine separately under the
microscope. A report is given telling us whether each biopsy
has cancer in it or not. Other information is also given such
as whether the tissue looked inflamed or whether there are
other features such as precancerous areas within the prostate.
Typically between 30-50 biopsy samples are taken and the whole
procedure lasts between 20-40 minutes.
At the end of the procedure the template is
removed and the perineum is injected with local anaesthetic.
A pressure dressing will be placed over the area to help
prevent any bruising. The pressure dressing and the catheter
are both removed after 6 hours.
What is the preparation
for Template guided biopsies?
You will be admitted to the Hospital a few hours prior to your procedure.
You will be sent an appointment to attend the preadmission clinic. Starving
instructions will be sent direct to your home address from the hospital.
After your admission you will be given an enema to ensure the back passage
is clear of any faeces, so that the prostate can be scanned by the ultrasound
You will be seen by Mr Lewi and your Consultant
Anaesthetist prior to your procedure, when you will be asked
to sign a consent form.
What are the side effects
of template guided biopsies?
Template guided biopsies carry no extra risk than a TRUS and biopsy.
Complications of both include:
- Bruising of the perineum than can
spread to the scrotum.
- Temporary discomfort in the back
passage area (most men).
- Blood in the urine for 1-2 weeks
- Blood in the semen for 72 hours
for most men (lasting up to 3 months in a few men).
- Prostatitis (inflammation or infection
of the prostate gland) (some men).
- Retention of urine requiring a
temporary catheter (2-10 in 100).
- Septicaemia requiring admission
to hospital (0-1 in 100).
- A few men experience temporary
What can I expect when
I go home?
You will be given a course of antibiotics and Tamsulosin tablets, to take home
and if necessary analgesia can also be arranged. You may experience some perineal
pain or discomfort after the procedure but Paracetamol or Nurofen should be adequate.
You should avoid aspirin or other blood thinning drugs for 24 hours as these
may increase the risk of bleeding.
You can expect to see some blood in your urine
for 14 days following the biopsies. You may notice some blood
in your semen for up to 3 months. If the bleeding becomes
excessive, prolonged or if you start to pass blood clots
then seek medical attention.
Occasionally swelling may occur in the prostate
gland as an inflammatory response to the biopsies being taken.
This could lead to difficulty in passing urine and may very
occasionally cause the ability to pass urine to stop completely.
This is known as urinary retention and you need to then have
a urinary catheter reinserted to drain the bladder. If this
happens the catheter will be left in place for a few days
or you will be instructed into how to perform self intermittent
There is a <1% risk of you developing septicaemia
following the biopsies. If you develop flu like symptoms
within 24 hours of the biopsies being taken (fever, cold
shivers, general aching) you should seek medical assistance
You should try and increase you fluid intake
for the 48 hours following your biopsies.
When can I go back to work?
We advise you to take 48 hours off work after the procedure.
When can I drive?
We advise you not to drive for 48 hours after the procedure but you will need
to check with your insurance company. You will need to feel comfortable performing
an emergency stop and check that any analgesia you are taking, if any, does
not impair your ability to drive.
When will my results be
You will receive an appointment to see Mr Lewi for your results through the post.
This is usually 7-10 days after your biopsies and the appointment is in the Outpatients
Department at Springfield Hospital.
If you have any further questions please do not hesitate to contact the team
as detailed below.
Sarah Buttle, Urology Nurse Specialist. 01245 234000 ext
Ward, 01245 234080.
Esther Kendall, 01245 234087.