In some cases, the assigned prostate biopsy?

In some cases, it may be assigned to a prostate biopsy

After initial examination by a urologist man can be assigned to a biopsy of the prostate. What is it, and when there is a need in this study?

Indications for

Prostate biopsy - one of the most accurate diagnostic methods, involving the taking of tissue samples from the prostate gland for later histological examination.

The need to clarify the diagnosis by biopsy exist in the following cases:

• Blood analysis revealed elevated levels of prostate-specific agent (PSA);
• during the digital rectal examination revealed changes in prostate structures (assemblies densification);
• during an ultrasound examination of the uneven density plots have been established;
• to assess the efficacy of the treatment.

Prostate biopsy is performed in cases when as a result of transurethral resection of had established the presence of abnormal cancer cells. For analysis, use the material obtained during operation.

This study allows to deliver the most accurate diagnosis: to ascertain the nature and prevalence of neoplasms, with prostate cancer to determine the stage of disease. Histological findings make it possible to determine the effective tactics of treatment and choose the most appropriate methods in each case.

Contraindications

Since the procedure for sampling tissue fragments of the prostate specific cause injury, it is counter-holding in such pathologies and conditions of the patient:

• when uncontrolled blood coagulation disorders;
• acute diseases of infectious etiology;
• under the general conditions of heavy patient;
• exacerbation of inflammation of the prostate;
• any injuries and inflammatory processes in the anus and rectum.

Methods of preparing biological material

Fence biopsy of the prostate gland is performed by several methods.

Depending on the mode of administration, the biopsy needle biopsy of the following types:

transrectal	The most convenient and frequently used method in which a tool is inserted into the rectum. The needle passes through the wall of the rectum and into the prostate, grabbing a small piece of tissue.
transurethral	A probe with a puncture needle is introduced into the urethra. The microscopic video camera on the end of the tool allows you to pierce the wall of the urethra at the level of the prostate gland and make the fence samples for research.
transperineal	In this case, the biological material is taken through a puncture in the perineum. The procedure is performed using an apparatus for ultrasound. This method is recommended for those patients in whom there are contraindications for transrectal biopsy.

How is taking a puncture

All manipulations are carried out with special tool - spring needle. During fires tissue sampling needle, and in its cavity remains small piece of tissue with a diameter of 1 mm and a length of 10 mm. To obtain more accurate performance of each material is controlled by an ultrasound or puncture microscopic camera.

For accurate results, tissue sampling is carried out from several areas of the prostate. Recently, experts prefer the method under which a 12 to 18 or more punctures.

Unlike sektantnogo method used previously, in which the two lateral lobes were selected by three samples, this method allows you to get a more complete picture of the state of the body and the presence in it of pathological processes. Puncture thus taken from all parts of the prostate, including those where the preliminary examination did not reveal any structural changes.

When there is a need for re- analyzes

In cases where the patient's PSA level is high, and histological analysis showed the presence of abnormal cells, is assigned to the re-examination of tissues. Repeated biopsy of the prostate may also be recommended for patients who during palpation or ultrasonography revealed no suspicious areas detected earlier.

Subsequent changes fences biopsy technique of taking tissue samples: scheme used over extended with an increased number of biopsies.

In most cases, complex diagnostic applies so-called saturation biopsy. The number of punctures thus increases to 22-25, and sometimes more.

This allows you to explore all areas of the prostate and a possible maximum accuracy the presence of cancer.

In the absence of complications as a result of the first repeat biopsy histology administered no earlier than 1,5-2 months. The optimal time interval between studies - 4-6 months. In the normal recovery after the intervention, and greater risk of development of cancer treatment can be repeated several times.

Preparation for manipulation

Prostate biopsy requires some preparation. Recommendations concerning preparatory activities gives the doctor.

Usually, they are as follows:

• 7-10 days prior to the planned the procedure should not take medicines that affect blood clotting;
• 3 days to stop taking any anti-inflammatory drugs;
• 1-2 days you should not be subjected to intense physical activities;
• the evening before the day of the procedure and in the morning just before the manipulation of the patient is put enema (This prevents the development of certain complications, as well as reduces the likelihood of inflammatory processes);
• Prostate biopsy is performed on an empty stomach, in the evening the patient shows a light dinner.

In order to prevent the development of inflammation after sampling biological material patient antibacterials can be assigned. You must start taking them for a few hours prior to the procedure, the general course of the reception usually lasts 3 days.

possible complications

Extraction of biological samples due to the trauma of the prostate, especially when a large number of punctures. In this regard, the procedure may cause some complications.

During the first days after the biopsy sampling observed such phenomena:

• small bleedings in the places extracting tissues manifesting slight bloody discharge in the urine or semen;
• pain in the perineum;
• exacerbation of chronic inflammatory processes in internal and external genitals;
• due to the swelling of the prostate observed difficulty urinating.

These complications are considered normal in the first 1-2 days after surgery. If there is deterioration, you must immediately contact a specialist.

Disturbing signs that require immediate medical attention include:

• the emergence of large blood clots, persistent blood discharge for several days;
• fervescence to 37,5- 38 degrees;
• the flow of urine is greatly complicated;
• appearance of blood discharge from the anus;
• amplification of pain.

Histological findings

Usually, cellular structure of the prostate tissue samples data are ready within 10 days. In the event of abnormal cells present the level of their development is determined on a scale of Gleason.

If the cells are in many respects similar to the normal, and the likelihood of developing cancer is low, the rate is from 2 to 4 units. Index at the level of 5-7 units indicates an average risk of developing cancer. With average 8-10 present the highest probability of aggressive development of prostate tumors.

A source: https://kaklechitprostatit.ru/diagnostika/provedenie-biopsii-prostaty.html

Prostate biopsy: how it's performed, indications, consequences

In some cases, the diagnosis of pathologies of the prostate can not be complete without making a Procedure, as prostate biopsy followed by cytological and histological analysis of samples obtained tissues. This kind of examination is one of the most informative and allows to accurately determine the presence of benign and malignant tumors in the body.

In this article we will acquaint you with the species, indications and contraindications, possible complications, methods of preparation and execution of prostate biopsy. This information will allow you to understand the essence of such a diagnostic procedure, and you can ask your questions to the attending physician.

Methods for performing the procedure

Prostate biopsy - the only method to determine the cellular composition of prostate tumors, ie, to diagnose cancer.

To collect the prostate tissue can be applied following techniques:

• sextant (or blind) - fence fabric runs through the lumen of the rectum, the doctor conducts finger Study gland by inserting a needle and finger controls its movement, lesions samples taken from 4-6 points;
• polifokalno - sampling tissues is performed under ultrasound apparatus, samples are taken from 12 points;
• carbonation - biopsy sampling is performed under ultrasound control, but the tissue samples were taken from 24 points.

Saturation method is the most advanced and can detect tumors even at the earliest stage of their development. Sextant method less often used for prostate biopsy tissue sampling, t. To. Becomes obsolete, not is capable of providing highly accurate sampling of the essential points of the gland and often gives false results.

Depending on the route of the fence prostate biopsy material can be:

• transrectal - performed through the rectum;
• transurethral - performed through the urethra;
• transperineal - is performed through a small incision in the perineum.

Multifocal transrectal biopsy

This technique can be carried out under the control of both the ultrasound device and the surgeon's finger. The procedure may be performed in different positions: on one side with the legs tightened to the chest supine with raised on legs or stand in jackknife position.

For anesthesia such method fence wire cloth local anesthesia.

Thereafter, for the control and manipulation performed accurately hit the biopsy needle in the required portions gland using ultrasound or surgeon's finger.

To collect samples of prostate tissue is used a special spring needle, which rapidly enters the breast tissue and quickly goes out of them. Such a method allows a biopsy to select up to 10 pieces of prostate tissues.

When performing multifocal transrectal biopsies under ultrasound monitoring procedure takes only a few minutes. If such a technique is performed by digital study, its duration can be about 30 minutes.

transurethral biopsy

This technique is performed using an endoscopic instrument (cystoscope) and special cutting loop. For transurethral biopsy is used general anesthesia, local, epidural or spinal anesthesia.

Patient is placed on his back on a chair with supports, foot rests. The urethral lumen introduced cystoscope, equipped with lighting and camera. The device is advanced to the level of prostate and by means of cutting the loop perform the necessary sampling tissue specimens from the most suspicious areas.

After sampling biopsy cystoscope is removed from the urethra. Duration transurethral prostatic biopsy can be from 30 to 45 minutes.

transperineal biopsy

This technique is less common, t. K. Is the most invasive and painful. To conduct transperineal prostate biopsy the patient is placed on his back with legs elevated or side with pressed against the chest limbs.

After the local anesthesia or general anesthesia doctor performs a small incision in the perineum and under the control of US enters through the biopsy needle into the prostate tissue. After collection of material needed for research needle is removed, and the incision sutured. The duration of such a biopsy is 15-30 minutes.

testimony

This diagnostic method is shown to all the men who have a sharp rise in the PSA level was found in the blood.

The primary indications for prostate biopsy tissue can become the following clinical cases:

• in the results for PSA analysis revealed increasing its level above 4 ng / ml;
• during palpation per rectum in prostate tissues was detected node or sealing area;
• during transabdominal or transrectal ultrasound in the gland was identified echogenic portion with low activity;
• need to control the course of the disease after TUR (transurethral resection of the prostate) or removal of the prostate via an incision in the abdominal wall through the bladder.

Re (t. e. secondary) Appointment of prostate biopsy is recommended in these situations:

• PSA level remains elevated or rising;
• the ratio between free and total antigen below 10%;
• antigen density higher than 15%;
• during the initial biopsy was discovered prostatic intraepithelial neoplasia is high;
• pick the number of prostate tissue at the initial biopsy was insufficient for testing.

Contraindications

In some cases, the implementation of a prostate biopsy may be contraindicated:

In some cases, professionals have to refuse to perform a prostate biopsy because of the categorical refusal of the patient from this diagnostic procedure.

How to prepare for the procedure

Prostate biopsy tissue is very similar to a minimally invasive surgical procedure and requires special preparation of the patient to the study. Before its implementation specialist will introduce the basic principles of patient biopsy and received his written consent for the performance of this type of survey.

To prepare for a prostate biopsy following a doctor's recommendation, you should:

1. One week prior to the procedure to stop taking drugs that cause liquefaction of the blood (Warfarin, heparin, Sinkumar, Aspirin-cardio et al.). 3 days before the study is necessary to abandon the non-steroidal anti-inflammatory (diclofenac, ibuprofen, etc.) And preparations based on hormones. If it is impossible cancellation of such drugs biopsy must be performed only in a hospital.
2. Before the study, patients were administered laboratory and instrumental diagnostic methods to exclude the presence of inflammatory processes. If these contraindications are detected, the process may be delayed until their elimination.
3. When having to perform a local anesthetic to the patient sample is performed at a local anesthetic to detect possible allergic reaction. As generally used gel 2% lidocaine for local anesthesia which is introduced into the rectum. Therefore, the sample is carried out on the portability of this particular anesthetic. If you plan to conduct the procedure with the use of intravenous anesthesia, spinal or epidural anesthesia, the patient is prescribed a consultation anesthesiologist.
4. One day prior to the procedure the patient should stop taking trudnousvoyaemyh products.
5. If for a biopsy to be used intravenous anesthesia, the last meal and liquid to take place for 8-12 hours before the procedure.
6. On the eve before the examination the patient should take a hygienic shower.
7. Before going to bed, and immediately before the procedure, your doctor may recommend acceptance sedatives to reduce patient anxiety.
8. To prevent infectious complications the doctor prescribes an antibiotic. The first reception of this preparation is done the day before the study and lasts for about 3-5 days (sometimes longer).
9. If you plan to exercise transurethral or transrectal biopsy, the day before and the morning before the test is conducted enema to empty the bowel.
10. If not planned execution of intravenous anesthesia, in the morning before the examination the patient can take a light breakfast.

Where the procedure is performed

Prostate biopsy may be performed as an outpatient or in the hospital. The walls of such research clinics may be performed without the need for intravenous administration of anesthesia, spinal or epidural anesthesia and general health risks to the side. In other cases, a biopsy is done only after the patient's hospitalization.

If the study is conducted with the use of intravenous anesthesia, spinal anesthesia or epiduarlnoy, then for 1-2 days, the patient should be under medical supervision. If there are no complications he can be discharged a few hours after biopsy or the next day.

Possible consequences

With the correct preparation of the patient and correct implementation of the prostate biopsy risk of adverse effects is minimal. In rare cases, may develop the following complications:

• discharge of blood in the urine due to intravesical or urethral bleeding;
• difficulty urinating (up to anuria);
• frequent urination;
• the presence of blood in the semen;
• pain in the rectum;
• perineal pain;
• discharge of blood from the rectum;
• development of acute prostatitis, epididymitis or orchitis;
• temperature increase;
• Complications caused by local or general anesthesia.

The reason for seeking medical attention can become prolonged (more than 3 days) or intensive bleeding, severe pain, inability to empty the bladder for 6-8 hours or development fever.

after the procedure

Within a month after prostate biopsy man should abstain from alcohol, caffeinated beverages, as well as products that irritate the urinary tract.

After performing a biopsy of the prostate patient is issued a medical certificate, and it is recommended to observe the following rules:

1. To refuse to take a bath, swim in the ponds, visit saunas, swimming pools or baths for 1 month.
2. Avoid hypothermia.
3. Unsubscribe from considerable physical activities and sports for 1 month.
4. During the month, avoid foods that contribute to irritation of the urinary tract, alcohol and caffeinated beverages.
5. During 7 days drink at least 2-2.5 liters.
6. Renounce sexuality 1-1.5 weeks.

results

Obtained after biopsy of prostate tissue are sent to a laboratory for further cytological and histological analysis. The results are usually available within 7-10 days after sampling.

In conclusion, the data may reflect the absence of lesions, the presence of inflammatory or neoplastic process.

The results of the detection of cancerous growths measured at Gleason table reflecting the degree of damage in the gradation 5 (or points):

• 1 - neoplasm consists of a single cluster of glandular cells and their nuclei are not changed;
• 2 - tumor consists of a small cluster of glandular cells, but they are separated from the healthy tissue sheath;
• 3 - tumor consists of tangible clusters of glandular cells and their germination observed in healthy tissue;
• 4 - consists of a reshaped neoplasm of prostate cells;
• 5 - neoplasm consists of a plurality of atypical modified cells which grow into healthy tissue.

1 gradation in Gleason maloagressivnomu corresponds to the type of cancer cells, and 5 - the most highly aggressive.

In addition to this assessment results in the amount of reflected analysis (or index) Gleason. This is done to assess the overall result, as at the time of biopsy taken several samples of abnormal prostate tissue. To determine the amount of Gleason summarizes the results of two samples with the largest tumors.

Gleason sum indices are estimated as follows:

• Index of between 2 and 4 - slow growing cancer and maloagressivny;
• index from 5 to 7 - moderately aggressive cancer;
• index of from 8 to 10 - an aggressive and fast-growing cancer with a high risk of metastasis.

Prostate biopsy and subsequent histological and cytological analysis of the sample makes it possible to accurately diagnose and to choose effective tactics of treatment of pathologies of the body. Performing such a highly informative diagnostic procedure justifies its invasiveness.

To which the doctor ask

Performing prostate biopsy can be administered by a urologist or oncologist. This kind of diagnosis is recommended for detection of suspected tumors in the tissues of the prostate or the need to evaluate treatment efficacy.

Specialist clinics "Moscow doctor" tells the story of transrectal prostate biopsy:

Transrectal biopsy of the prostate gland

Specialist clinics "Moscow doctor" tells about the consequences of prostate biopsy:

A source: https://myfamilydoctor.ru/biopsiya-prostaty-kak-provoditsya-pokazaniya-posledstviya/

In some cases, the assigned prostate biopsy?

Prostate biopsy - a diagnostic procedure that is performed in a hospital with to obtain a sample of prostate tissue for further histological or cytological research.

Note that in this procedure pleasant enough, because it is characterized by a pervasive interference with sexual male organ.

But there is good news: a biopsy is performed under local anesthesia or under the influence of painkillers, so too the procedure is not considered a disease. In addition, this operation is widely used in medical practice around the world.

If you or your loved ones have appointed such a diagnosis, we offer you through our publications to learn about it as much as possible. In particular, today we look at the cases in which prostate biopsy is appointed.

Thus, the diagnosis of a sample of the prostate is usually carried out for ascertaining the nature of prostate cancer, in particular, is suspected of malignancy. Note that the biopsy is the most reliable method of research.

This procedure is used primarily or repeatedly. In the first case the diagnosis is performed after the ultrasound prostate or digital rectal examination in which the doctor has found sealed formation. To confirm or deny your suspicions, the doctor recommends the patient to be examined, which is called a prostate biopsy.

To conduct such a procedure recommended also with increasing PSA level in the blood (PSA). It was he who testifies to the appearance of cancer in the prostate gland, or the transition of benign tumors in prostate cancer.

Re prostate biopsy is indicated for the control of the results, even if the histological examination revealed no malignancy. In addition, with continued growth of PSA also requires repeated diagnostics. If you pick up the material found atypical cells, indicating the beginning of the cancer process, the biopsy procedure is repeated.

It hurts?

Most of the patients prior to prostate biopsy experienced a real shock, imagining that it's just terrible for painful procedures. In fact, everything is not so bad: during the sampling of the material you will feel slight prick. When administered to a patient the needle is also feeling minor discomfort.

But due to the fact that this procedure is very short, the pain pass quickly. Sometimes during a biopsy of the prostate adenoma patient feels pain in the pelvic area. In addition, after the examination for a few days a slight amount of blood may be released during urination.

However, these symptoms pass quickly.

In rare cases, but nevertheless, such a study is carried out and under general anesthesia. After surgery, the patient is left for several days in the hospital. During the first day may feel fatigue, nausea, mild headache.

Are there any contraindications?

In acute inflammatory diseases of the prostate or rectal biopsy is not carried out until the complete elimination of inflammation. That is why before the prostate tissue examination the doctor usually recommends to pass common blood and urine tests to get the required results.

If you are taking medications that thin the blood and reduce its clotting, that too is a relative contraindication for biopsy. This procedure is not carried out in the presence of the rectum of feces, so before the diagnosis necessarily need to do a cleansing enema.

Can there be complications after the biopsy?

Unfortunately, the procedures can be complicated by the following symptoms:

• blood in urine or feces;
• violation of urination;
• urinary retention;
• temperature increase;
• development of acute prostatitis or orchiepididymitis.

In order to reduce the risk of inflammatory processes doctor prescribes antibiotics for the day before the procedure, and for 3 days afterwards.

Take care of yourself and stay healthy!

A source: https://menportal.info/story/v-kakih-sluchayah-naznachaetsya-biopsiya-prostaty

Prostate biopsy: indications and types of result

A biopsy of the prostate is one of the diagnosis not only for this benign neoplastic processes but also cancer, Moreover, this method provides the greatest amount of information about the tumor, allowing the later to use the most effective ways treatment.

prostate biopsy

Morphological study, which is possible only after the biopsy - this is the most accurate method of diagnosis, without which a lot of other non-invasive tests - almost guesswork.

In other words, a doctor may suspect anything, but not knowing exactly how breast tissue is constructed, if there malignant tumor and the extent of its differentiation, is powerless in the fight against a disease that It remains unclear.

The tumor continues to grow, the therapy is not appointed, and pathology can go into running shape, when even the most radical treatment is useless.

In many clinics, and to this day have used outdated methods of biopsy, which is quite painful transferred to men, but because the fear of the procedure often causes patients from her refuse.

However, even in the absence of opportunities to do a biopsy in a modern way, the doctor can always offer examinee anesthesia option, explaining the importance of the study and the possible consequences in case of failure of the him.

If the urologist after the laboratory tests and ultrasound urges conducting a prostate biopsy, then give up because of fear of pain is meaningless: growing tumor will bring much more problems, perhaps - will shorten the life, whereas a short intervention, even if it is uncomfortable, allow prescribe treatment time and even completely eliminate the cancer.

Indications and contraindications to the study

Pathological examination of the prostate is most often associated with the suspicion of a malignant growth. The reason for it may be:

• Detection of suspicious areas by ultrasound;
• The growth of index of prostate-specific antigen (PSA) over the age norm;
• Palpable through the rectum into the prostate education;
• The need to clarify onkoprotsessa stage when the diagnosis was made in the course of removal of adenomas or cancer due to a benign tumor.

Repeat biopsy may be given if:

1. There is an increase in PSA index;
2. Elevated PSA does not decrease after the conservative treatment of non-oncological pathologies;
3. PSA density higher than 15%;
4. Is an increase in the total amount of PSA, when free protein attitude becomes lower than 10%;
5. Revealed intraepithelial neoplasia is high during the initial examination;
6. Initial biopsy was not informative because of insufficient volume of the tissue.

Contraindications to the study - relative, that is, the procedure will be possible after appropriate preparation of the subject. The only absolute obstacle to the analysis considered the failure and unwillingness of the men surveyed. In this case, the maximum urologist explains in detail all of the risks and that with which the patient may face if neglect biopsy.

Taking prostate parenchyma for analysis is limited when:

• Regular intake of blood-thinning agents (requires their cancellation);
• Rectal bleeding (cracks, hemorrhoids);
• Acute or exacerbated chronic proctitis;
• Acute inflammation of the prostate gland;
• Filled with the contents of the rectum.

Also, the study can not be carried out under severe disorders of blood coagulation, decompensated pathology of internal organs, severe infectious diseases prior to their full treatment, mental disorders, when it is difficult to contact surveyed. In each case, the question of expediency and diagnostics can be solved individually.

How to prepare for a prostate biopsy?

Preparation for prostate biopsy plays an extremely important, because the invasive manipulation, that is, eliminate the risk of complications can not be. To the negative effects have arisen, the patient must strictly follow the recommendations of the urologist, in preparation for the upcoming study.

Before a biopsy is necessary to:

1. Pass the general analysis of blood, urine;
2. Make coagulation;
3. To pass urine for bacteriological sowing;
4. Undergo ultrasound of the prostate gland.

If necessary, appointed by the ECG, ultrasound of the abdominal organs, kidneys and other studies in accordance with the co-morbidities. A man can ask the result of x-rays, tests for HIV, hepatitis and syphilis.

If a man is taking anticoagulants, they are sure to cancel no later than one week before the planned biopsy. Nonsteroidal anti-inflammatory drugs stopped three days before the procedure.

Failing drug withdrawal, a biopsy is performed under stationary conditions.

In addition, the patient is required to notify the physician of all its existing diseases, allergies (especially - in the anesthetics and other drugs).

In the evening before the test is recommended to remove the hair from the crotch, take a shower, dinner should not be abundant. In the morning there should not be, because a biopsy is performed on an empty stomach. All patients underwent enema the day before the study, because the contents of the intestine not only hampers the introduction of instruments in the intestine, but also increases the risk of infection.

To prevent infectious complications apply antibiotics, fluoroquinolones, which are received prior to the study, receiving their proceeds to a week afterwards.

Almost always, a prostate biopsy - a patient event, and only occasionally may require hospitalization (with severe cardiovascular disease, it is impossible to cancel anticoagulants).

A biopsy often involves anesthesia. For this purpose, one may use special rectal gels with lidocaine or injection forms of anesthetics administered as the movement of the needle in the space around the prostate.

Varieties and techniques of conducting a prostate biopsy

Depending on the number of points where made taking biopsies are isolated:

• Sextant biopsy - tissue taken from six points;
• Multifocal - used most often, the fence of the parenchyma of 10-12 seats;
• Saturation biopsy - removal of tissue is not less than 20 points, shows the men who have enlarged the study did not allow a diagnosis, while laboratory findings and the patient talk about pathology present.

Prostate biopsy is done in different ways. For example, access can be carried out through the rectum - then say transrectal biopsy. This kind of procedure - the most common.

If the endoscope to the biopsy needle is inserted through the urethra, we are talking about transurethral biopsy. This method differs pain and a higher risk of complications, so rarely used transrectal.

When there is no possibility of a puncture prostate through the rectum or urethra biopsies taken transperineally: under the control of ultrasound performed an incision of the skin of the perineum, which is introduced biopsy needle, move deeper into until the prostate parenchyma.

Blind prostate biopsy is not performed, since, firstly, it may lead to serious complications, and, secondly, modern medicine has visualization capabilities needle stroke.

The easiest and most affordable way to control is the use of ultrasound.

If it is impossible ultrasonic inspection must be undertaken cautiously biopsy on digital rectal examination, but this manipulation is not as informative and carries a high risk.

Today, surgeons use Automatic device for the biopsy of the prostate, making it possible to make the procedure fast and low-impact.

Special gun contains a needle moving in the parenchyma and takes her for a split second.

Ultrasound, supplementing the study helps to clarify the shape, the volume of the iron present in her lesions, spend biopsy sighting of the modified fragments, but the parenchyma of the peripheral part of the body is also necessary is taken to analysis.

Immediately before the procedure prostate biopsy examinee changes into a clean gown, takes linen, placed on the left side or back legs with divorced or are in the jackknife position. The crotch region is processed antiseptic and hides sterile tissue, the examinee must not touch her hands, and the surgeon operates under sterile gloves.

transrectal biopsy

Transrectal biopsy is performed under ultrasound control or finger and lasts about half an hour. In the first case, the sensor is placed in the lumen of the intestine, and before taking the fabric urologist introduces an anesthetic in the form of a gel.

Transrectal biopsy performed a special needle, which rapidly enters into the fabric and goes back since the biopsy specimens in less than a second. Thus it recovered to 12 bars parenchyma gland.

In the intestine after transrectal art tampon is placed, which prevents bleeding. He removed the next day.

In the absence of the ultrasonic sensor surgeon can carry out research under the control of its own finger placed in the rectum. The needle should be in the course of the finger is rotated in the gland body for different puncture points and extracted to the outside. This method is less common, it is not as accurate as the use of ultrasound.

transurethral biopsy

Transurethral species assumes the position of the subject on the backRequires anesthesia, in some cases - total as very painful. Surgeon in the urethra enter special endoscope with a camera and a light source, as well as a loop to cut tissue. The procedure lasts up to 45 minutes.

Chrespromezhnostnaya biopsy is used less often than other methods of operation. It is indicated for the narrowing of the rectum, anus after bowel resection performed. Examinee is laid on its side or back with legs given to the abdominal wall, the local anesthesia is carried out or in the form of general anesthesia.

Fabric crotch cut into small extent where the biopsy needle is inserted, rotated in the parenchyma of the body at the time of collection of material. The rectum is the surgeon's finger, fixing the prostate gland. At the end of the manipulation of the needle is removed, and the iron is pressed to stop the bleeding. Manipulation requires approximately 30 minutes.

One option is a prostate biopsy fusion biopsy. Before taking tissue iron scanned magnetic resonance imaging, as a result of the physician receives a three-dimensional body image.

This image is superimposed on an ultrasound, which allows to increase the accuracy of biopsies and make it possible sighting.

With this type of operation is taken at least 18 gland fragments access - through the crotch and under general anesthesia.

Video: Report on fusion prostate biopsy

The above described process is carried out as a biopsy of the prostate adenoma, so research focal changes, including - if already diagnosed cancer earlier.

Obtained by any of the methods of breast tissue is placed in a container with formalin and sent to the histopathology laboratory with the direction in which the specified passport data of the men, a presumptive diagnosis and features of applied technology biopsy.

Most men are afraid of the pain during the study. It can be felt at the time of the puncture needle body, but as a rule, quite tolerable. Some discomfort is due to stay in the rectum of the ultrasonic sensor or doctor finger.

patients often require repeat biopsy shown if the primary study outcome was not significant or remained doubts about the tumor. It is awarded when:

1. PSA index increases by more than 0.75 ng / ml per year regardless of the outcome of the primary biopsy;
2. There are signs of atypia or severe dysplasia (intraepithelial neoplasia) in the initial evaluation;
3. Possible non-radical cancer radiation;
4. There are new Palpable nodes or rejection ultrasound missing previously;
5. Is suspected carcinoma recurrence.

Differences repeat biopsy of the primary consist in the fact that the tissue is taken from the peripheral, and from the border areas, is available in both cases. A second procedure may be carried out after 3-6 months after the primary, it is usually accompanied fence parenchyma of a greater number of points.

The consequences of a prostate biopsy

After an outpatient biopsy man can go home after a few hours or even sooner if signs of complications will not arise, urination will be painless and without blood in the urine. In the next 4:00 patient should refrain from strenuous exercise and weight lifting, the wheel is better not to sit down. Sex life should be excluded for the next week.

In the next few days may cause slight pain in the pelvis, urine can carry an admixture of blood, after transrectal biopsy possible bleeding from the gut. If a biopsy is performed through the urethra, then a few hours may be left with a catheter, be sure to - antibiotics.

Blood in the urine after a biopsy - one of the most common consequences of the operation. A slight admixture of it is not considered a cause for concern in the first 3 days after the study, however abundant or prolonged bleeding or lasting longer than three days hematuria - a reason to see a doctor to rule out complications.

Prostate biopsy may give some complications:

1. Infection - especially likely when accessing through the intestine and the presence of not diagnosed inflammation in the prostate, is prevented by antibiotics;
2. Hematuria - Blood in the urine due to injury of the urethra or of the bladder wall;
3. Rectal bleeding after 3 days from the date of the study;
4. An allergic reaction to an anesthetic;
5. Soreness in the perineum and rectum;
6. Acute prostatitis;
7. Acute urinary retention;
8. Inflammation of the testicles and their appendages;
9. Fainting and collapse during the study.

The most difficult and dangerous of biopsy is considered the consequences of infection with sepsis. Fortunately, such a development is extremely unlikely, as well as other negative effects, so prostate biopsy is considered a safe study.

To the doctor should be treated immediately in the event of fever, severe pain in the abdomen or pelvis, the inability to empty the bladder for more than 8 hours of heavy bleeding.

Evaluation results of the biopsy

Results of a biopsy of the prostate gland can be found after 7-10 days after surgery.

Analyze them should a specialist, who will explain the essence of the patient revealed pathology and talk about further actions.

In view of the complexity of interpretation of findings of pathologists, do not try to put a diagnosis on their own, in order to avoid erroneous judgments of unprofessional and unfounded fears.

The results may indicate the presence of prostatitis, which is like a tumor, provokes an increase in PSA, but it does not pose a threat to life. Frequent benign tumor-like processes - hyperplasia and adenoma. About a third of patients who have an elevated PSA in the blood, by means of a biopsy diagnosed with cancer.

A biopsy of the prostate adenoma is carried out in connection with increasing PSA levels.

It is likely that the conclusion of limited true benign tumor - an adenoma or diffuse hyperplasia of the prostate, often occurs in older men.

However, a detailed histological examination allows both microcarcinoma find areas that are inaccessible to non-invasive diagnosis and rule out the possibility of the tumor.

scale Glisson

To evaluate the histology in the prostate Gleason scale is used, recognized all over the world's most valuable diagnostically. For this purpose, in biopsies selected two most characteristic in the structure for the formation zone, and determined for their scores based on the degree of differentiation, the structural features gland cell atypia.

Points 1-2 correspond to the tumor, which is not beyond the prostate capsule and is surrounded by a kind of healthy tissue.

Starting with 3 points and 5 carcinomas are invasive growth, grow into healthy surrounding tissue and organ going beyond the limits. Summing scores obtained on the scale Glisson from 2 to 10.

The higher it is, the malignant carcinoma and the lower the degree of differentiation.

Counting result at a specified scale, morphology enables the urologist not only the total score of the tumor, but also indicates that from this amount the sum. For example, the total score 4 can not conform to both sprouting tumor in healthy tissue (2 + 2), and carcinomas, which starts an active invasion (1 + 3). It is important to assess the behavior of the tumor in the future.

Result prostate biopsy Gleason scale allows the oncologist to draw conclusions about the prognosis of the disease, as well as to pick up better for the variety of cancer treatment regimens. It is important to note that the absence of tumor cells in biopsy does not exclude the possibility of cancer, so many patients continue to systematically surveyed.

Video: Report on a biopsy of the prostate gland

A source: http://operaciya.info/urologia/biopsiya-predstatelnoj-zhelezy/