The incidence of prostate cancer has been increasing year by year in recent years. Early stage prostate cancer is not subjective and conditions such as hematuria and bone pain usually do not appear until late stages. The advent of prostate-specific antigen has made early diagnosis of prostate cancer possible. Recommendation: Men over the age of 45 should have an annual physical examination related to the prostate gland. This allows prostate cancer, especially high-risk prostate cancer which is a serious threat to human life, to be managed at an early stage and improves the prognosis.
Prostate puncture biopsy is the gold standard for prostate cancer diagnosis. However, due to the lack of understanding of this invasive procedure, which causes fear in some patients, some patients do not fear the procedure, but are particularly afraid of puncture biopsy. From time to time, there are patients with significantly elevated PSA; anal exams and MRI clearly show prostate occupancy who are still hesitant to undergo prostate puncture biopsy. This not only delays the disease, but also causes metastasis of some limited prostate cancer that could have been treated in time, resulting in adverse consequences.
The following are some of the questions that are routinely encountered.
Q1: What is a prostate puncture biopsy? Under what circumstances is it necessary?
A1: Prostate puncture biopsy is an invasive pathological examination performed to obtain a small amount of prostate tissue through a fine needle into the prostate gland to confirm the diagnosis of prostate tissue disease.
A prostate puncture biopsy is required when the following problems are found.
1, rectal finger examination, ultrasound, MRI found prostate swelling, the nature of the swelling needs to be determined.
2.For patients with suspected prostate cancer with elevated serum PSA.
3.Patients determine the histological type of prostate tumor by puncture biopsy in order to decide the treatment plan.
4.To determine the effect of prostate cancer after treatment.
Q2: Will prostate puncture biopsy cause tumor metastasis?
A2: Many patients will have the worry that if it is prostate cancer, will the puncture cause tumor metastasis?
Prostate puncture biopsy is a mature diagnostic technique that is safe, reliable and has few serious post-operative complications, and is basically free of tumor metastasis.
Q3: What preparations are needed before puncture?
A3: First of all, routine blood tests should be performed to determine whether there are contraindications to puncture such as infection, anemia, thrombocytopenia and bleeding tendency. Patients who are taking drugs that affect coagulation, such as aspirin, poliovirus, or low-molecular heparin, should stop taking them for more than a week before puncturing, otherwise the puncture may cause unnecessary hemorrhage.
An electrocardiogram is also necessary for elderly patients. In addition, patients should take 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.
Q4: Is a prostate puncture biopsy very painful and hard on the body? Can it be performed in elderly patients?
A4: Currently, there are two main approaches: transrectal puncture and transperineal puncture. There is discomfort during the placement of the ultrasound probe into the rectum and some pain for patients with hemorrhoid disorders. Transrectal puncture is basically painless. Trans-perineal puncture may be slightly painful during local anesthesia in the perineum (i.e., between the anus and the testicles), but as long as the patient is not a chronic alcoholic, the local anesthetic medication works quickly and effectively, making the subsequent puncture operation less painful.
Prostate puncture is a minimally invasive operation with minimal systemic effects, so most patients, including elderly patients, can tolerate it, except for a small number of patients with serious medical disorders and contraindications.
Q5：What do I need to pay attention to after a prostate puncture biopsy?
1. Patients may feel dizzy when sitting up after puncture due to postural hypotension or reaction to anesthetics, which are normal reactions.
2, generally after the puncture, anti-inflammatory drugs should be taken; some patients need to take hemostatic drugs.
3. Please try to get out of bed as little as possible on the day after puncture, and do not use too much force in stool.
4, after the operation may appear hematuria, such as the first part of the urine has a slight hematuria are normal, especially in the morning the first urine color may be darker, patients and family members do not need to be too nervous, the symptoms of hematuria can be gradually relieved within a week. 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 the catheter needs to be left in place to stop the bleeding.
5. Cover the puncture wound with gauze after the operation, and remove the gauze by yourself one day after the puncture.
Q6: How long does it take for the puncture result to be known?
A6: The general hospital pathology report cycle is about 5 working days, (e.g. Monday to Friday, if there is a national holiday in between, the date will be extended, i.e. if the puncture is done on Friday, the report will be available only on the following Friday)
If there are difficulties in distinguishing tissue sections and complex immunohistochemical staining is required, the time will be extended accordingly.
Q7: Do I need to be hospitalized for the puncture and what is the cost?
A7: In our hospital, hospitalization is generally required for patient safety reasons.
The cost is approximately 600 RMB for the disposable puncture needle and the rest is covered by medical insurance.