Transrectal Ultrasound (TRUS) Guided Biopsy Of The Prostate

What is a TRUS biopsy of the prostate?

TRUS biopsy is a method of sampling the prostate to establish a diagnosis of prostate cancer. An ultrasound probe is passed in to the rectum or back passage to visualise the prostate and multiple samples (biopsies) are taken from the prostate through the rectal wall using fine biopsy needles. It can be performed under local anaesthetic, or light general anaesthetic.

What are the potential complications of TRUS biopsy of the prostate?

The TRUS biopsy method is usually well tolerated. Patients may occasionally have some burning when they pass urine for the first few days after the procedure. Almost every patient sees blood in his urine or bowel motions or semen, but this settles within a few weeks. Don’t be alarmed if there appears to be quite a lot of blood in the first 24 hours, as this will usually settle spontaneously. Intermittent blood may be seen for up to 6 weeks after surgery. Occasionally patients have difficulty passing urine and a catheter or urine drain may need to be inserted.

TRUS biopsy has a small but significant risk of serious infection, where bacteria may enter the bloodstream. Septicaemia is a serious illness that requires admission to hospital for intravenous antibiotics and close monitoring. It is important to be alert to the symptoms of infection after TRUS biopsy. If you have a fever and feel unwell, particularly in the first 3 to 4 days after biopsy, then you need to present to your nearest hospital.

How is infection minimised with TRUS biopsy?

The rate of TRUS biopsy related infection is 1-2% of cases. This risk is minimised by commencing antibiotics 2 nights prior to your biopsy and completing the course after your biopsy. In addition, if you have travelled to China, Southern or South-East Asia in the last 6 to 12 months the risk of infection is higher, and either an alternative form of biopsy will be offered or a special rectal swab will be taken to make sure you are not harbouring any resistant organisms.

When do I get my biopsy results?

The pathology results are usually available within 1 week after a biopsy. Your urologist will discuss these results with you at an appointment in the consulting rooms. You should continue with the antibiotics that were prescribed to commence 2 nights before the procedure.

  • Royal Australasian College of Surgeons (RACS)
  • Sydney Adventist Hospital
  • American Urological Association (AUA)
  • Australian Medical Association (AMA)
  • Norwest Private Hospital
  • The University of Sydney
  • European Association of Urology (EAU)