Transrectal prostate biopsy

Gold standard: Safe and uncomplicated

Because it is safe and easy to perform, transrectal ultrasound (TRUS)-guided prostate biopsy is still the gold standard for further clarification if there is evidence of prostate cancer. It is performed on an outpatient basis under local or short general anesthesia. Under ultrasound control, at least 12 biopsies are taken through the rectum from all areas of the prostate gland, and 18-24 biopsies for larger prostates. If areas suspected of being tumorous are visible in the imaging, an additional targeted biopsy is taken from these areas of the prostate (MRI-supported prostate biopsy). The locations of the respective sample collection are documented so that they can be reliably assigned later on for planning a possible treatment. 

No spread of tumor cells through biopsy

Usually, the prostate biopsy is performed without complications. After the tissue is removed, small amounts of blood are often found in the urine, sperm or stool, or a slight feeling of pressure in the rectum. In rare cases, pain, temperature increase, fever or chills may also occur. In these cases, the doctor should be consulted immediately, as in a few cases (less than 1 percent) there is a possibility of prostate inflammation. Clarification is also necessary if there is heavy bleeding from the rectum or urethra or circulation problems. To reduce the risk of infection through the puncture site in the rectum, the German Society of Urology recommends antibiotic prophylaxis. 

As recent studies have shown, there is no spread of tumor cells in the puncture canal or a promotion of the development of tumor metastases. Nor does the biopsy influence the growth of prostate cancer.

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