TP Prostate Biopsy

What is a TP Prostate Biopsy?

A transperineal (TP) prostate biopsy takes small tissue samples from the prostate gland. It passes through the perineum (the area of skin between the scrotum and anus). At LivingCare, our consultant urologists perform TP prostate biopsies using advanced imaging guidance to ensure accurate sampling. It's typically performed under local anaesthetic, allowing most patients to return home the same day.

How a TP Prostate Biopsy Works

An ultrasound probe inserted into the rectum gives real-time imaging, whilst biopsy needles are inserted through the perineal skin. Using a specialised grid system, the urologist can accurately map the prostate and take tissue samples from predetermined locations,

What Can a TP Prostate Biopsy Be Used For?

TP biopsy serves as the definitive diagnostic test for prostate cancer. At LivingCare, our Urologists commonly recommend it following an MRI scan, if it has revealed any suspicious lesions requiring tissue confirmation, and to investigate concerning symptoms such as difficulty urinating or blood in urine when cancer is suspected.

What to Expect When Receiving a TP Prostate Biopsy

Before Your Appointment
‍Your urologist will explain the procedure. You'll receive specific instructions about any blood-thinning medications you take. You'll typically be prescribed antibiotics to take before and after the procedure. On the day, eat lightly and arrange for someone to drive you home.

During Your Appointment
‍You'll be positioned comfortably whilst the perineal area is cleaned with an antiseptic. A local anaesthetic is injected to numb the area – you may feel a brief stinging sensation as it's administered. An ultrasound probe is gently inserted into the rectum to visualise your prostate. Using ultrasound guidance and a biopsy grid, the urologist systematically takes tissue samples for examination. You'll hear a clicking sound as each sample is taken. The procedure typically takes 20-30 minutes under local anaesthetic.

After Your Appointment
‍You'll rest briefly in recovery for 30-60 minutes. It's normal to experience some perineal discomfort for a few days and to notice blood in your urine, semen, or stools for up to two weeks. Results typically take 7-14 days, and you'll have a follow-up appointment to discuss findings with your urologist.

Risks and Complications of a TP Prostate Biopsy

TP biopsy is generally very safe, with significantly lower complication rates compared to transrectal biopsy. Side-effects can include blood in the urine for several days, blood in the semen for several weeks, minor perineal discomfort, and traces of blood in the stools. Less common complications affecting 1-3% of patients include urinary retention requiring temporary catheterisation, urinary tract infection, and temporary increased urinary frequency.

Serious complications are rare (less than 1% of cases) and include significant bleeding, severe infection or sepsis (extremely rare at under 0.5%), and acute urinary retention requiring hospital admission.

How to Recover Following a TP Prostate Biopsy

During the first day or two, you should rest at home and avoid strenuous activity. Drink plenty of fluids and take regular pain relief if needed. Avoid aspirin and ibuprofen to begin with, as they can increase the risk of bleeding. Apply ice packs to the perineal area if you experience swelling.

During the first week, you can gradually return to normal activities, although you should avoid heavy lifting or vigorous exercise. You can return to work within 2-3 days for desk jobs. Continue drinking plenty of fluids, and avoid sexual activity for at least one week. Most men feel completely recovered within one to two weeks.

References

• ‍NHS – Prostate Biopsy
• ‍British Association of Urological Surgeons (BAUS) – Transperineal Prostate Cancer UK – TP Prostate Biopsy