For a doctor with several years of clinical experience, it is easy to see a strange phenomenon in patients with prostate disease – they are not afraid of surgery, but are especially afraid of puncture biopsies. There are often patients with significantly elevated PS answers (even to 10ng/ml or more); anal exams; and MRIs that clearly show prostate occupancy who are still hesitant to undergo a prostate puncture biopsy. This not only delays the condition, but also allows some limited prostate cancer that could have been managed in time to metastasize, resulting in adverse consequences.
”The prostate puncture biopsy may seem mysterious to some patients, and the fear of some patients may also come from a lack of understanding of this invasive procedure. The actual fact is that you can find a lot of people who are not able to get a good deal on this.
The current lifestyle in China is gradually being influenced by western countries, leading to a yearly increase in the incidence of prostate cancer. As far as the condition is concerned, the initial stage of prostate cancer does not have any subjective feelings, and conditions such as hematuria and bone pain usually do not appear until the late stage. But now with the advent of prostate-specific antigen, early diagnosis of prostate cancer has become possible. It is recommended that men over the age of 45 should undergo an annual prostate related physical examination so that prostate cancer can be managed at an early stage and the prognosis can be improved.
The following are some of the questions that are routinely encountered, but additional questions can be added if you have any.
What is a prostate puncture biopsy? When is it necessary?
A prostate puncture biopsy is an invasive pathological examination performed to confirm a disease of the prostate tissue.
The procedure is performed by inserting a fine needle into the prostate and extracting thin strips of prostate tissue for the purpose. The use of this procedure is increasing because it is more precise, accurate and has a high positive biopsy rate.
A prostate puncture biopsy is required when the following problems are found.
1. to determine the nature of the prostate mass.
2. to determine the histological type of the prostate tumor in order to decide the treatment plan
3. to determine the outcome of prostate cancer after treatment
4.For patients with elevated serum PS answer, clinical symptoms and rectal examination suspected to be prostate cancer.
Will prostate puncture biopsy cause tumor metastasis?
Many patients will have the worry that if it is prostate cancer, will the puncture cause tumor metastasis?
With the development of prostate puncture needles, prostate puncture biopsy has become safer and more reliable, and there are fewer post-operative complications and basically no worry about tumor metastasis.
What do I need to do before puncture?
First of all, routine blood tests should be performed in the outpatient clinic or ward to determine whether there are contraindications to puncture such as anemia, thrombocytopenia and bleeding tendency. Patients who are taking drugs that affect coagulation, such as aspirin, poliovirus, or low molecular heparin, need to stop taking them for more than a week before puncturing, otherwise the puncture may lead to unnecessary hemorrhage.
An electrocardiogram is also necessary for elderly patients. In addition, patients should consume antibiotics for a few days prior to the puncture to prevent post-puncture infection.
The night before the puncture, the patient should fast after dinner and take oral laxatives to empty the bowels as a bowel preparation.
Prior to the puncture, the health care provider will provide relevant health education to the patient and family and sign an informed consent conversation.
Steps of prostate puncture biopsy
Currently, there are two main access routes: transrectal puncture and transperineal puncture, with ultrasound-guided transperineal puncture predominating in our hospital. The procedure is usually performed by a urologist and an ultrasonographer.
1. The patient is first asked to take the cystotomy position, i.e., lying on his back with his legs bent apart on the hospital bed.
2. The ultrasound probe is placed in the rectum (there will be discomfort during the procedure and some pain for patients with hemorrhoid disorders.
3. routine disinfection and spreading of towels.
4, anesthesia (1% lidocaine in the perineum: the location between the anus and the testicles) for local anesthesia, during which may feel a little pain, but generally as long as the patient is not a long-term alcoholic, the effect of local anesthetic drugs quickly and more obvious, so that after the puncture operation basically do not feel pain).
5, the puncture operation generally takes 8~10 stitches of the specimen (if there are obvious nodules, additional puncture is performed on the nodules to increase the positive rate).
6.After the operation, cover the puncture wound with gauze, which can be removed by yourself one day after the puncture.
Patients may feel dizzy after sitting up due to postural hypotension or reaction to anesthetics, which are normal reactions.
The total operation time is approximately 20 minutes.
What do I need to pay attention to after a prostate puncture biopsy?
1. Generally, anti-inflammatory and hemostatic medications should be consumed after the puncture procedure.
2. Please try to stay out of bed as little as possible on the day after the puncture and do not use too much force in the bowels.
Generally speaking, if there is some hematuria in the front part of the urine every time you urinate, it is normal, especially in the morning when you urinate for the first time, the color may be darker, patients and their families do not need to be too nervous, the symptoms of hematuria can be gradually relieved within a week.
4. If there is a blood clot or hematuria in the whole process, it is necessary to explain to the doctor that the cause may be more serious damage to the urethra and a catheter needs to be left in place to stop the bleeding.
How long does it take to know the results of the puncture?
The usual hospital pathology reporting period is about 5 working days (e.g. Monday to Friday, but if there is a double day off in between, the date will be extended, i.e. if the puncture is done on Friday, the report will not be available until the following Friday)
If there are difficulties in resolving tissue sections and complex immunohistochemical staining is required, the time will be extended accordingly.
Do I need to be hospitalized for the puncture, how long does it take and what are the costs?
In our hospital, for patient safety reasons, hospitalization is usually required for about 3 days, and the cost is about 600 RMB for the disposable puncture needle, while the rest is covered by medical insurance.