Transperineal targeted prostate biopsy

A transperineal biopsy of the prostate is a diagnostic procedure that is used to take small tissue samples from your prostate gland.

During the procedure, your consultant will use an ultrasound probe to create images of your prostate, as well as information from your previous MRI scan, to accurately guide a needle to the area to take samples of your prostate tissue. The samples removed are analysed under a microscope and the results are sent back to your consultant.

The biopsy results will show whether your prostate cells are cancerous, or if your cancer has changed. It can also diagnose other conditions such as benign prostatic hyperplasia (BPH), prostatitis and prostatic intraepithelial neoplasia (PIN).

Why do I need a transperineal targeted prostate biopsy?

If you’ve had an MRI scan that showed some abnormalities in your prostate, your consultant may recommend a transperineal targeted prostate biopsy. They may also suggest one if you have:

• High PSA levels in your blood
• A lump on your prostate that was found during a digital rectal examination

The biopsy will be performed under local anaesthetic so you can eat and drink as normal before your appointment. You should continue taking medication as normal before your procedure, however, you may need to stop any blood-thinning medication before your biopsy. We’ll discuss this in more detail with you.

Before the procedure, your consultant will examine your prostate and assess its size and feel.

Once you’re ready, your consultant will insert an ultrasound probe into your back passage. This feeds an ultrasound image onto a screen which will be used to guide the biopsy needle into your prostate. Your consultant may also use your previous MRI scan to guide the needle.

Before performing the biopsy, your consultant will apply a local anaesthetic to the area to reduce any discomfort. After checking your prostate is numb, they’ll insert the needle through the perineum and into the prostate.

Once a small number of samples have been taken, a firm dressing will be applied to the insertion site. You’ll be asked to stay in the centre until you’ve passed urine, after which you can go home.

You should allow around one hour for your appointment, the procedure itself will last 30 to 45 minutes.

Your consultant will organise a second appointment with you to discuss your results usually seven to 14 days after your biopsy. If a cancer is found, they’ll explain your diagnosis and treatment options, listen to your concerns, and answer any questions you may have.

There are complications that may occur as a result of your biopsy. Your consultant will explain all of these before your procedure.

You should let us know straightaway if you have any signs of infection after your procedure, including:

• A high temperature
• A lot of difficulty passing urine
• A need to pass urine very often
• A lot of blood in your urine or stool
• Shivering or shaking
• Inability to pass urine

Other side effects may include:

• A small amount of blood in your urine and stool
• A small amount of blood in your semen – this won’t harm you or your sexual partner
• Bruising in your back passage or around the insertion site
• Discomfort in your prostate caused by the bruising
• Difficulty in getting or maintaining an erection

We’re recognised by all major private medical insurers and also offer a range of self-payment options. A GP referral is not always necessary. For self-paying patients, the cost for a transperineal biopsy starts from £1,750 (excluding consultant fees). Find your nearest centre offering transperineal targeted prostate biopsies to book an appointment.