Transrectal ultrasound (TRUS) guided biopsy

Your doctor might take a sample of tissue from your prostate gland to look for cancer cells. This can be done during a transrectal ultrasound. It can help to diagnose prostate cancer and is called a biopsy.

You might have an MRI scan before your transrectal ultrasound guided biopsy.

What is a transrectal ultrasound guided biopsy?

This is a type of needle biopsy to look for cancer cells in the prostate. Your doctor takes a series of small tissue samples from the prostate to examine under a microscope.

You have the biopsy through your back passage (rectum) using a transrectal ultrasound scanner.

Diagram showing a TRUS biopsy

Preparing for your TRUS biopsy

You have the biopsy in the outpatient department.

Your nurse will ask you to sign a consent form once they have given you information about the procedure.

You can't have a TRUS biopsy if you have a urine infection. Some hospitals might get you to do a test before you have the procedure. Or just check with you that there's no pain when you wee. 

You take antibiotics to stop infection developing after the biopsy. You have a dose of antibiotics before the biopsy, and then for a couple of days afterwards.

Eating and drinking and medicines

You usually have a TRUS biopsy under local anaesthetic, so you can generally eat and drink normally beforehand and afterwards. 

Take your usual medicines as normal, unless your doctor tells you otherwise. But if you take warfarin to thin your blood you should stop this before you have your biopsy. Your doctor will tell you when you need to stop taking it.

What happens

In the biopsy room

Before you have the biopsy, your doctor shows you the ultrasound machine and the very fine needle they use to take the tissue samples. It can make quite a loud noise, so it’s good to expect this. Your doctor will explain the whole procedure before they start and you can ask any questions. 

During the biopsy

First, you lie down on your left side. Your specialist injects local anaesthetic into your back passage (rectum), to numb the area.

The doctor puts an ultrasound probe into your rectum to examine your prostate. To get the samples of prostate tissue, they push the fine needle along the ultrasound probe and into the prostate gland.

This is a little uncomfortable but doesn’t take long. You feel a slight jolt each time the doctor takes a sample. 

This might happen up to 12 times as the doctor takes the different tissue samples. The whole procedure takes about 20 minutes.

After the biopsy

After the test, you have a rest and a drink. You can then go home. The team monitors you for at least 30 minutes afterwards. It is very important to drink a lot of fluids for the next 24 hours.

Side effects

Transperineal biopsies are safe tests but there are some possible side effects. Side effects might include:

  • bleeding
  • infection
  • pain

Drinking plenty of water flushes out the blood and helps to stop you from getting any infection. Contact your doctor straight away or go to the accident and emergency department (A&E) if you have signs of infection, such as:

  • a high temperature
  • difficulty passing urine
  • a need to pass urine very often
  • a lot of blood in your urine or poo
  • shivering or shaking

You need to have antibiotics straight away if you have a urine infection.

Possible risks

This test is a safe procedure but there are some possible risks.

These are:

  • ongoing bleeding
  • infection
  • pain
  • not getting enough biopsy samples

Your doctor or nurse explain these when you sign your consent form. Ask them any questions you have about the possible risks.

Getting your results

Your scan will be looked at by a specialist doctor and you should get your results within 1 or 2 weeks. You won't get any results at the time of the scan. 

Waiting for test results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact them if you haven’t heard anything after a couple of weeks.

You might have the contact details for a specialist nurse. You can contact them for information and support if you need to. It may help to talk to a close friend or relative about how you feel. 

For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

Contact the doctor that arranged the test if you haven't heard anything after a couple of weeks.

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