Diagnosing prostate cancer - having a transperineal prostate biopsy

Written by: Professor Francis Chinegwundoh MBE
Edited by: Bronwen Griffiths

1 in 8 men in the UK will receive a diagnosis of prostate cancer in their lifetime. The prostate is a male gland located between the bladder and penis, surrounding the urethra. The prostate grows in size with age and its main purpose is to help make semen, which is the fluid that carries the sperm. Prostate cancer risk also increases with age, and hence men over the age of 50 are encouraged to be tested regularly for prostate cancer. Professor Francis Chinegwundoh MBE, a renowned urologist, explains how prostate cancer can be diagnosed with a transperineal prostate biopsy.

What is a prostate biopsy?

A prostate biopsy is a procedure whereby samples of the prostate gland are taken by a urologist and sent to a histopathologist for analysis. It is the means by which prostate cancer is diagnosed.

Why do I need a prostate biopsy?

If there is a suspicion that a man may have prostate cancer, either because the PSA blood test (prostate specific antigen is a chemical made by the prostate gland that is found in higher levels in the bloodstream when prostate cancer is present) or because the prostate gland feels abnormal when examined by a finger in the rectum, then a prostate biopsy is required. Generally, an MRI scan of the prostate gland is undertaken beforehand which may guide the urologist as to where to take samples of the prostate from.

How is a transperineal biopsy performed?

A transperineal prostate biopsy is the most accurate way of diagnosing prostate cancer. A needle is passed through the skin in the space between the testicles and the back passage (anus) and into the prostate gland. The man lies on his back with his legs held up, allowing the biopsies to be taken. In most cases, it is done under a general anaesthetic, but increasing numbers of urologists are performing such biopsies under a local anaesthetic. A transperineal biopsy does not cause pain, although there may be discomfort in the perineum afterwards where the skin has been punctured several times.

Is a prostate biopsy painful?

A transperineal biopsy has advantages over the transrectal biopsy route, in that the infection risk is lower and the prostate can be better sampled.

How long does it take for the results to come through?

The results are generally available 7-10 days after the biopsy.

By Professor Francis Chinegwundoh MBE

Professor Francis Chinegwundoh MBE is a renowned consultant urologist based in London, who specialises in treating prostate cancer, benign prostate enlargement, erectile dysfunction, and a wide variety of other urological conditions. Professor Chinegwundoh also provides medicolegal services. In addition to treating patients, he is a widely published researcher, lecturer, and professor, actively involved in teaching and also involved in charity work as Chairman of the charity Cancer Black Care and a trustee of Tackle prostate cancer. He was recognised with an MBE in 2013 for services to the NHS.

Since qualifying in medicine in 1984 from the University of London, Professor Chinegwundoh has accrued a wealth of experience and expertise. He obtained a Master of Surgery degree in 1994 and more recently a Master of Medical Law in 2010. He is a Fellow of the Royal College of Surgeons of England and Edinburgh as well as a Fellow of the European Board of Urology. He established and runs the regional prostate low dose brachytherapy service at Barts Health NHS Trust. He has performed over 100 transurethral needle ablation of the prostate for benign prostate enlargement and over 1500 transperineal template prostate biopsies. He is also a medical legal expert.

Professor Chinegwundoh is currently urology lead at Newham University Hospital, Barts Health NHS Trust and past chairman of the Prostate Cancer Advisory Group. He serves as an honorary clinical senior lecturer at Queen Mary’s College, University of London and has been an honorary visiting Professor in the School of Health Sciences, City University, London since December 2014.

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