What is a prostate ultrasound and biopsy, and why might I need one?

Your prostate can cause problems with passing urine or you might have a family history of the disease. You may be asked to have a prostate ultrasound and needle biopsy to check for prostate cancer.

How do I get a prostate ultrasound and biopsy?

Although you can have a prostate ultrasound and biopsy privately or by the NHS, in most cases your first step is usually a visit to your GP. The GP may examine your prostate gland and order a blood test for prostate-specific antigen (PSA) based on your signs and symptoms. A PSA test is not always conclusive, and if the GP suspects prostate cancer, they can urgently refer you to the NHS for further tests.

You will be referred to a doctor who specialises in urology (male reproductive system). They may have a consultation before or organise your investigations first, depending on your referral.

The procedure can be undertaken as outpatients or day case, depending on your type of anaesthetic.

Before your procedure

Your doctor will discuss the benefits and risks (e.g. bleeding, pain) before the procedure.

If you find the procedure too painful or distress, you should let the clinical team know who will stop the procedure.

What happens on the day of surgery?

For most prostate ultrasound and biopsy, you will arrive, have your procedure and go home all on the same day – this may be in a clinic or day case area.

Your doctor will explain what will happen, pain relief options and answer any questions. You will be asked to sign a consent.

When having the procedure done, you may be given:

  • Local anaesthetic to numb your genital area.
  • Spinal anaesthetic to numb the lower half of your body by an injection in the back
  • General anaesthetic to make you unconscious, so that you will feel nothing during your operation
  • You may also be offered sedation (medicine to relax you).

The time of procedure can vary but usually 10-20 mins. During the procedure, your urologist will perform the procedure.

You will be asked to lie on your side and bring your knees to your chest, or lie on your back with your legs in supports.

The area being tested will be numbed, although this process can itself be painful.

A lubricated ultrasound probe will be inserted into your rectum.

A small biopsy needle is inserted using the probe to take tissue samples from your prostate so that they can be tested for cancer cells. You may feel pressure or discomfort during this.

You can ask to stop the procedure at any time.

Tissue samples will be sent to the lab for analysis.

Recovery and what to expect after your prostate ultrasound and biopsy

After the operation you will go back to the ward or waiting area. You will go home once you feel well enough. If you have a general anaesthetic or sedation, you will not be able to drive.

Some urologists may prescribe an antibiotic after the biopsy to prevent infection.

Complications of an ultrasound and biopsy

All surgical operations carry a risk of complications. Your risks can increase the older you are, particularly if you have other health problems. Your surgeon will discuss any specific concerns with you before your operation.

Common – 1 in 100 people which is equivalent to one person on your street

  • Soreness or pain a few days after the procedure.
  • Blood in urine and/or stool

Rare – between 1 in 1,000 and 1 in 10,000 people which is equivalent to one person in a town.

  • Urinary tract infection
  • Prostate infection

Contact the hospital where you had your operation if you develop:

  • Unable to urinate
  • Fever and/or chills
  • Excessive bleeding
  • Excessive pain

Follow-up

What happens next will depend on your test results and whether the biopsy samples show that you have a prostate cancer diagnosis. You may be sent for an MRI scan to assess how far the cancer has spread and will have an appointment with your consultant to discuss your biopsy results, (including your Gleason Score which measures how aggressive the cancer is) and what happens next in terms of cancer treatment options, potentially including prostate surgery .

Costs and fees

Prostate needle biopsy and ultrasound is available free of charge through the NHS. Private healthcare may offer faster access or a broader selection of consultants.

The procedure is available through private medical insurance. Check with your insurer which hospital or consultant they will cover it.

You can also self-fund a biopsy and ultrasound. Typically, an initial consultation with the surgeon will cost between £150 and £300. The cost of the operation itself will vary depending on the exact surgery you need will also vary depending on where you live.

If you opt to self-fund you will be offered one of the following:

  • An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this.
  • A ‘fee-per-service’ deal, where you pay for each part of your treatment and the services you use separately. You often will not know the full costs until you receive invoices.

For more information, you can read our guide on self-pay .

References

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