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Transperineal Prostate Biopsy

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TRANS PERINEAL PROSTATE BIOPSY PATIENT INFORMATION LEAFLET This patient information leaflet will tell you what to expect when you have your prostate biopsy Your doctor or nurse will be happy to answer any additional questions you may have If you have been recommended this treatment by your consultant please note that this recommendation has been made in your best interests What is a Transperineal TP Prostate Biopsy The prostate gland is in front of the back passage rectum During your prostate biopsy a doctor will take small samples of tissue from your prostate gland These samples are then sent to the laboratory to be examined under a microscope by a Consultant Pathologist Continue to take your medications as normal unless your doctor has told you not to If you are taking medicine to thin your blood you will be given instructions about when to stop this before the procedure During a transperineal or TP biopsy your doctor will gently guide a needle into your prostate through the skin behind your testicles see diagram below An ultrasound probe will be passed into your rectum back passage to scan your prostate Guided by a combination of ultrasound and your MRI scan several biopsies will be taken from your prostate gland through your perineum the skin between your scrotum and rectum In Beacon Hospital we perform this procedure under general anaesthetic as a day case procedure This means that you will be asleep during the procedure and not feel the samples being taken What Should I do Before my Prostate Biopsy Tell your doctor if You are taking any medication especially blood thinners Warfarin Plavix Xarelto Pradaxa Eliquis Lixiana You have had a prostate biopsy before You have taken antibiotics in the last 6 months You have any allergies including to anaesthetic You have ever had any bleeding problems You have an artificial heart valve Trans Perineal Prostate Biopsy

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Risks Associated with Transperineal Biopsy Include Blood in the urine for up to 10 days Almost all men Blood in your semen for up to 6 weeks This may be red or a brownish colour Almost all men Bruising of the skin in your perineal area Discomfort in your prostate caused by bruising from the biopsy Up to 1 in 2 men Between 1 in 2 and 1 in 10 men Inability to pass urine acute retention of urine 1 in 20 men Temporary problems with erections caused by bruising after the biopsy 1 in 20 men Infection in your urine requiring antibiotics 1 in 100 men Passing clots of blood and bleeding in your urine that require admission to hospital 1 in 100 men Septicaemia infection in your blood requiring emergency admission to hospital for treatment Less than 1 of men What Happens on the Day of my Prostate Biopsy The TP prostate biopsy is usually carried out as a day case Due to the anaesthetic you will not be able to drive yourself home after the biopsy so you will need to arrange transport When you arrive in the hospital a sample of your urine will be checked for signs of infection If you have a urine infection we will have to postpone your biopsy until this has been treated Before Your Biopsy Beacon Hospital will advise you about the arrangements for your operation You will be contacted by the scheduling department the day before your procedure with an admission time You will check in at the Surgical Day Unit Reception on the first floor You need to be fasting for at least 6 hours before surgery This includes ALL food AND drinks even including water and chewing gum If your procedure is in the morning please fast from midnight If you have an afternoon slot please fast for at least 6 hours prior to your admission

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It is advised to shower the morning of your procedure or the night before if you have an early admission time Please bring a list of your medications with you when you come in If you are unsure of the names or dosages of these ask your pharmacist to print off a list before your appointment Bring a list of previous operations or medical conditions where applicable You may be advised to take some of your regular medication the morning of your procedure If so please do so with only a small sip of water The only jewellery allowed is a wedding band Please leave all valuables at home This includes jewellery cash watches etc Bladder On Your Arrival Please check in at the Day Unit Reception on the first floor where you will be registered before being escorted to your cubicle You will be asked to provide a urine sample on arrival A nurse will take your medical history blood pressure temperature and pulse If you are feeling unwell it is important to mention this to the nurse You will need to put on a gown and disposable underwear Two hospital bands will be applied containing your name date of birth and hospital number These will be confirmed with you on arriving at each different department You will have an enema before your biopsy About an hour before your biopsy you will be given an antibiotic This is to help reduce the risk of a urine infection developing after your biopsy Men over 50 will routinely have a tracing of their heart ECG taken before anaesthetic This is a standard procedure and the tracing will be assessed by your anaesthetist Rectum Prostate Gland Prostate Your belongings will be locked away on the ward in the lockers provided This includes any dentures and glasses You will be brought to the Radiology Department to sign your consent form with the consultant who will perform your procedure and meet the anaesthetist

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Please note that at times delays can occur in the department We ask for your patience at such times After Your Procedure You will wake up in the Recovery Room where the nurses will monitor you until you can return to the Day Unit Please use the call bell if you need to use the bathroom or get out of your bed If you experience pain at this time alert your nurse who will take appropriate measures to relieve this You should take the painkillers offered by your nurse to alleviate any pain you are feeling You will be given an absorbent pad to place inside your underwear as there may be a small amount of bleeding from the skin punctures or from your urethra water pipe Light refreshments will be provided You will need to pass urine before you go home The nurses will contact your next of kin to come and collect you The nurse will explain your after care instructions follow up appointments and or prescription with you prior to your discharge You will be given another antibiotic tablet to take 12 hours after your prostate biopsy It is important that you take this antibiotic You may need to speak with your Consultant before you go home or this may be done in a follow up appointment in their rooms When You go Home Drink 1 5 2 litres of fluids while there is visible blood in your urine You are advised not to drink alcohol for at least 24 hours You may have discomfort in the biopsy area for a couple of days if you need to you can take Paracetamol or your usual pain killer medication follow the instructions on the medication packet You are likely to see blood in your urine and semen Drink plenty of fluids usually about 1 5 to 2 litres per day while there is blood visible in your urine This helps to flush the blood through Avoid vigorous exercise for 2 days

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When Should I Seek Advice or Help If you develop any of the following symptoms contact the Urology Day Unit on the numbers listed in this information leaflet Pain when passing urine Cloudy and offensive smelling urine You are unable to pass urine despite having a full bladder and drinking plenty of fluid You have a high temperature or have chills fever or shivering When Can I Expect my Results You will get an appointment for a follow up with your Consultant in rooms from your consultant s secretary You can bring a family member or friend with you when you are getting the results Contact Numbers If you are concerned about your health after the procedure you can contact any of the below Urology Department 08 00 17 00 hours 01 293 6042 Nursing Supervisor out of hours 01 293 7535 Your Local Emergency Department

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Beacon Hospital Sandyford Dublin 18 D18 AK68 Tel 01 293 6600 www beaconhospital ie Version 1 10 2021

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