NHS Foundation Trust Michael Heal Department of Urology Transrectal Ultrasound with Prostatic Biopsy Every Matters 1
Introduction You have been referred to the Michael Heal Department of Urology for investigation of your prostate gland. In order to obtain further information, we need to obtain some tissue from your prostate. The tissue is obtained by the use of a fine needle, the position of which is controlled by ultrasound scan. The procedure is known as Transrectal Ultrasound and Prostatic biopsies (TRUS & Bx). You will be awake for this procedure. Procedure and Preparation Prostate biopsy controlled by ultrasound scan is usually carried out as a day case. If you are on warfarin therapy please contact your GP regarding this as an alternative may be required. You need to stop your warfarin 5 days before your appointment due to the increased risk of bleeding. Your INR levels will be checked on the day of your procedure. Failure to stop your warfarin will result in your biopsy being cancelled. It is important that you have your bowels opened, ideally on the morning of your procedure or the previous night. We have sent you a 3 day course of antibiotics. The first antibiotic needs to be taken 2 hours before your appointment time. N.B. If you are allergic to any antibiotics, please inform the Urology Outpatients Department as soon as possible. Telephone 01270 612235 (direct dial). 2
Procedure on arrival at Urology Outpatients Department When you arrive in the department, you will be greeted by a member of the nursing staff and shown where to change into a gown. You will be shown into the examination room and asked to lie upon a couch on your left hand side. The doctor will then examine your back passage and prostate and then he will pass an ultrasound probe into your rectum. The doctor will then be able to see pictures of your prostate gland on a television monitor after administering a local anaesthetic. The doctor will then pass a very fine needle along the ultrasound probe and use this to obtain several tiny pieces of tissue from the prostate for microscopic examination. The needle is attached to a firing mechanism, which makes a snapping noise when activated. At the end of the procedure, you will be encouraged to drink plenty of fluids. You may expect to see a small amount of blood in the bowel motion. You also can see traces of blood in your semen for up to 6 weeks following your biopsy. 3
Advice after procedure You can expect to be in the department for 2-3 hours, as we will need to ensure that you are passing urine with no problems before you go home. It is important that you drink plenty of fluids for the rest of the day. This helps to prevent infection in the urine and helps to clear any blood that much more quickly. You should avoid any heavy lifting, driving a car or strenuous exercise for at least 24-48 hours to avoid a further risk of bleeding from the prostate gland. Before you leave the department the staff will arrange for you to come back and see the Urology Nurse Specialist to discuss the results of the biopsies. This will be approximately 14 days following your biopsies. Some common questions answered Does the procedure hurt? Most patients find the procedure a little uncomfortable but not painful. Before the procedure the staff will discuss giving you some pain relieving drugs. (Local anaesthetic) It is important that you let the staff know if you are finding the procedure too painful so that they can help. Are there any complications? The main complication of prostatic biopsies can be urinary infection. This is the reason why you will have been given antibiotics to take before and after the procedure and why you are advised to drink plenty of fluids once the biopsy has been carried out. 4
Symptoms The symptoms to look out for are: - Shivering or shaking High fever Severe difficulty passing urine Marked frequency of urination Excessive blood in the urine or bowel motion If you experience any of the symptoms mentioned after you have been discharged, you are urged to telephone the Michael Heal Department of Urology on 01270 612235 between 9am - 5pm or your own family doctor after 5pm Summary Transrectal ultrasound and prostatic biopsy is a safe procedure, which provides the Urologist with valuable information about the prostate. It allows for direct examination of prostatic tissue under the microscope, which is essential to establish whether further treatment is required. If you have any concerns about the procedure then please discuss them with the nursing or medical staff. 5
Further Information If you require any further information please contact: Urology Nurse Specialist Michael Heal Department of Urology Leighton Hospital Middlewich Road Crewe CWI 4QJ Direct Line: 01270 612011 Questions? Make a note here 6
This leaflet is available in audio, large print, Braille and other languages. To request a copy, please contact the Patient Information Co-ordinator. 7
You can use car parks E or F (which have disabled parking), located closer to the department. For access to these enter via Middlewich Road following signs for Treatment Centre. Michael Heal Department of Urology Leighton Hospital Middlewich Road Crewe, Cheshire CW1 4QJ Direct Line: 01270 612235 www.mcht.nhs.uk NHS Choices www.nhs.uk Printed on paper sourced from sustainable forests. IMPRESSIONS DESIGN & PRINT 01270 767661 Revised and reprinted August 2012 Review August 2014 Ref: SC/MHU/0040812