Fusion Prostate Biopsy

MRI guided trans-perineal prostate biopsies are performed in men with an abnormality visible on prostate MRI. The abnormal area seen on the MRI scan is accurately targeted by computer assisted ‘fusion’ of the MRI images with live ultrasound images.

Compared to non-guided biopsy this allows more accurate detection of significant prostate cancer, often with the passage of fewer needles into the prostate. Trans-perineal biopsies have a very low risk of infection.

Procedure

The abnormal area on the MRI scan is outlined by the urologist.

At the time of biopsy a general anaesthetic is given. An ultrasound probe is inserted into the lower rectum to view the prostate gland. The MRI image with outlined abnormal area is overlayed onto the live ultrasound image.

A biopsy needle is then guided into the abnormal area and several small samples of prostate taken. Sampling of other areas of the prostate may also be undertaken.

The procedure takes 25 minutes to complete. Usually you are able to go home the same day. If the biopsy has been performed in the afternoon then staying overnight is a possibility. Before leaving hospital you need to pass urine. There will be temporary swelling and bruising of the perineum and scrotum. It is normal for blood to drip from the urethra and be seen in the urine for several days afterwards, this may even last for two weeks or more, especially in men who take blood thinners such as aspirin. There may be blood in your semen for up to six weeks following biopsy.

Pre-procedure

Aspirin, clopidogrel, dabigatran, warfarin and any other blood thinning medications will need to be stopped prior to surgery. We will advise you when to stop and re-start these medications A urine sample needs to be provided to the laboratory 1 week prior to surgery.

Risks

There is a very small risk of urinary blockage (urinary retention) following biopsy. If you feel that voiding has become difficult then contact us or attend the Emergency Department, as a catheter may need to be temporarily inserted. Some men experience temporary impairment in erections following biopsy. This is due to bruising of the nerves that cause erection & usually resolves within three months.

Return to Work

Following your biopsy we recommend that you take three days off work.

Results

The biopsies are sent to the pathology laboratory. We usually have the results within ten days. An appointment will made to discuss the results with you.