Prostate Ultrasound Scan and Biopsies. Macclesfield District General Hospital

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1 Prostate Ultrasound Scan and Biopsies Macclesfield District General Hospital Urology For clinical enquiries phone Ultrasound For appointment enquires phone Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 1

2 Introduction This leaflet explains the procedure for having a prostate ultrasound scan and biopsies at Macclesfield District General Hospital. Why do I need a prostate ultrasound scan? We carry out a prostate ultrasound scan to get more information about the size, shape and texture of the prostate gland. You may need a prostate ultrasound scan for one of the following reasons. your prostate may have felt firm or irregular when it was examined. your blood test may have shown higher than normal levels of PSA. (prostate specific antigen). PSA is a chemical which the prostate gland releases. Increased levels of PSA may suggest a problem, for example, infection, inflammation or growth of the prostate, or a benign tumour, or a malignant tumour (cancer). a scan will give us valuable information about your prostate. What is the prostate gland? The prostate gland is part of the male reproductive system. It is at the base of the bladder and goes around the urethra (the pipe you pass urine through). Bladder Prostate Urethra As you get older, the prostate may become enlarged or change in a way which can lead to problems, such as finding it difficult to stop or start passing urine. Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 2

3 What does a prostate scan and biopsy involve? A scan allows us to obtain pictures and measurements of the prostate gland without using x-rays. It uses high-frequency sound waves which are transmitted from a probe which the doctor will put in your back passage. These sound waves form a picture which the doctor can see on the ultrasound screen. While the probe is in place, pictures will be obtained of the prostate. The doctor will then inject some local anaesthetic to make the procedure more comfortable. This may sting a little as the local anaesthetic is injected. For some people, the procedure may be painful, however the majority will only experience a mild discomfort. It is usual to take approximately 12 biopsies (samples of tissue) - six from the left side of the prostate and six from the right side. The doctor will then send the biopsies to the pathology department where they can be examined under a microscope. The results are not available immediately. You will be contacted by telephone or letter with a clinic appointment for results. What to expect when you arrive in Ultrasound When you arrive at the hospital you will be asked to provide a urine sample which is tested for infection. The doctor performing the procedure will go through the risks and explain the procedure to you again. There is a small risk of infection associated with prostate biopsies. To reduce this risk, you will be given an antibiotic tablet one hour before the procedure. As well as this you will be given intravenous antibiotics (antibiotics given into the vein) prior to the biopsies being taken. This is done by a doctor or a nurse inserting a cannula (a small tube) into the back of your hand. The antibiotic is then injected through the cannula. Important We need to know if you have had any antibiotics in the last eight weeks and if so, the name of that antibiotic. Failure to provide this information will result in the procedure being delayed or postponed. It is useful if you bring with you a recent prescription so that we can see what medication you are taking. What we need to know about you If any of the following apply to you, you will need to contact the Urology Department before you come for your appointment. This is very important information and we may have to delay your procedure if you are takin anti-coagulants and have not stopped them before the procedure. If you are allergic to any antibiotics e.g. penicillin please let us know. Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 3

4 If you are taking medication to prevent your blood from clotting called Anticoagulants. These are some examples: Warfrin or Sofarin Clopidogrel or Plavix Dabigatran Etexalate Acemocoumarol Enoxaparin or Clexane Phenindione Ardeparin or Indaparin Dipyridimole or Persantin or Asasantin Abciximab Eptifibatide Rivaroxaban Tirofiban Ticlopidine Asprin Fondaparinux Sinthrome (Acenocoumarol) Apixaban (Eliquis) Fondaparinux or Arixta PF There are many anticoagulants prescribed and it is important if you are on one that is not on the list you let us know. You have epilepsy. You have had a joint replacement within the last 12 weeks. You can contact the Urology Department on / from 8.30 to 5pm Monday to Friday. It is fine to bring somebody with you for this appointment. If you have a morning appointment please make sure you eat breakfast, if you have an afternoon appointment please eat lunch before you attend. Are there any side effects? If you only have an ultrasound scan, there are no side effects. If you have biopsies taken, you may notice some blood in your urine, motions and semen; this can last for up to several weeks. We recommend that you drink 2-3 litres of fluid for 2 days after the biopsies this will help to flush out any blood in the urine. It is important that you do not overdrink as this can cause you to feel unwell. The recommended fluid intake is 2 litres per day and this includes tea and coffee. If the bleeding becomes heavy and will not stop, and you have any pain or difficulty passing urine, contact your GP or the Urology Department during office hours on or or you may need to attend the Accident & Emergency Department. Despite giving antibiotics, there is still a small risk of infection following the procedure. Approximately 2% (2 in every 100) will get am infection that will mean admission to hospital for intravenous antibiotics. Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 4

5 It is really important that if you feel unwell with flu-like symptoms, shivering or a high temperature within 48 to 72 hours of the procedure, with a high temperature and shivering and shaking that you get to the Accident and Emergency Department immediately. It may be necessary to get an ambulance so that you can receive treatment quickly. Please do not drive yourself if you are unwell. If you do have an infection you will be given intravenous antibiotics and you will remain in hospital. Serious or frequently occurring risks Common Blood in urine, motions and semen this can last anywhere from 1 day to several weeks Occasional Urinary tract infection Heavy bleeding Difficulty passing urine Rare Infection in blood stream requiring admission to hospital You will be given a discharge information sheet after your scan and biopsies. Alternative procedures There is no alternative to this procedure. Other important information Avoid strenuous exercise for 48 hours after the procedure. You can eat and drink as normal before attending for your appointment. Contact us Macclesfield DGH / Urology Secretaries Macclesfield DGH Urology Nurse Specialist Macclesfield DGH Appointment queries Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 5

6 Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 6

7 Comments, compliments or complaints We welcome any suggestions you have about the quality of our care and our services. Contact us: Freephone: Phone: Textphone: Customer Care, Reception, Macclesfield District General Hospital, Victoria Road, SK10 3BL For large print, audio, Braille version or translation, contact Communications and Engagement on East Cheshire NHS Trust operates a smoke-free policy (including e-cigarettes) For advice on stopping smoking please contact the KICKSTART Stop Smoking service on East Cheshire NHS Trust does not tolerate any form of discrimination, harassment, bullying or abuse and is committed to ensuring that patients, staff and the public are treated fairly, with dignity and respect. If you have any comments about how we can improve our services please inform a member of staff in the department or complete a comment card available throughout the hospital. Macclesfield District General Hospital, Victoria Rd, Macclesfield SK10 3BL Leaflet Ref: Published: Oct 2018 Review: 30/09/2021 Page 7

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