Transperineal Prostate Biopsy (TPBP)

The prostate is a gland found only in men. The prostate gland is located below the bladder and is the size of a walnut. The function of the prostate is to produce fluid found in the ejaculate to help sperm.

You have been recommended to have a Transperineal Biopsy if you are at risk of early prostate cancer. This may be indicated through an abnormal digital rectal examination or if you’re PSA (Prostate specific antigen) is elevated (or both).

Traditionally, a Transrectal Ultrasound Guided biopsy was used. This procedure had some risks of infection or septicaemia as biopsies were taken straight through the bowel wall. Recently the rate of those complications has been rising, so we have moved away from the traditional method and are now offering an approach which has a much lower rate of infection.

A Transperineal biopsy involves having a probe inserted into the rectum and a grid positioned between the scrotum and anus (perineum). Using the grid, very fine needles are passed through and a number of biopsies are taken. These are sent to the pathologist. The biopsy can find out whether any of your prostate cells have become cancerous. Your specialist will contact you by phone to discuss results with you when they become available. This can take up to 3 days.

This procedure requires a general anaesthetic and you will only be required to attend as a day case. You must arrange to have a family member or friend drive you home.

Sometimes complications can develop following your procedure, including:

  • Difficulty passing urine (as long as you don’t have a urinary tract infection, this is normal and will resolve. It is important to maintain a high fluid intake for a few days)
  • Blood in your semen (this is normal and can persists for up to 8 weeks)
  • Blood in the urine (this is normal and needs to be monitored. Increase and maintain a high fluid intake for a few days)
  • Erectile dysfunction (this occurs in less than 3 % of patients and in majority of patients it does resolve. There are conflicting reports regarding this, however, may be up to 3%)
  • Infection – (up to 10 fold less common than for a Transrectal Biopsy)

Following your procedure, it is important to maintain a high fluid intake and a regular bowel routine.

Please call the rooms during normal hours or attend your nearest emergency department if the following symptoms are experienced:

  • Fever
  • Increased pain
  • Unable to pass urine for more than 6 hours and/or if you are in discomfort
  • Persistent bleeding not resolved by increased fluid intake