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The generally accepted indications for an ultrasound guided prostate biopsy are:
NOTE: The ultrasound guided prostate biopsy can sometimes be carried out through the perineum, called a trans-perineal approach.
Cessation of warfarin with INR measured on the day before the procedure. The exact value for INR required to render the procedure ‘safe’ is determined by the individual radiologist carrying out the procedure.
Antibiotic cover. This is optimally provided with oral norfloxacin 400 mg bid, commencing the day before the procedure, and often continued for a total of 7 days. Norfloxacin is the antibiotic that best penetrates the prostate gland. Trimethoprim is an acceptable substitute.
Absence of an anus or rectum, for example after rectal resection, precludes a trans-rectal approach, but a perineal approach can be used in this circumstance.
Intercurrent infection. This includes prostatitis. It is appropriate to wait until the infection is cured before proceeding with a biopsy.
Similarly, anticoagulation must be ceased and an INR less than 2 is required.
mild – very common;
severe, requiring admission to hospital and surgery or transfusion – very uncommon.
Haematuria (>60%, and usually mild. Clots may be passed).
Haematospermia (>90%. Small clots may be seen and the ejaculate may be brownish). May persist for over 2 weeks.
Septicaemia (<1%): occurs usually 12–72 hours after the procedure. Must be rapidly treated with antibiotics and may require hospital admission for IV antibiotics.
There is no specific special care that need apply after an ultrasound-guided prostate biopsy.
Magnetic resonance imaging guided prostate biopsy is not currently carried out in Australia.
Finger-guided prostate biopsy is carried out by some urologists, usually only if there is a very obvious palpable abnormality.
Trans-rectal Ultrasound Guided Prostate Biopsy:
Prostate Biopsy Procedure, Effects, Uses, Complications, and More:
Prostate Biopsy Procedure:
Page last modified on 26/7/2017.
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RANZCR® intends by this statement to exclude liability for any such opinions, advices or information. The content of this publication is not intended as a substitute for medical advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Some of the tests and procedures included in this publication may not be available at all radiology providers.
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