How is a prostate biopsy performed?
Biopsy is the most accurate method of laboratory research. It is used in the diagnosis of various diseases. It is most often used to confirm or refute an oncological diagnosis.
Conducting a prostate biopsy gives a detailed picture of the state of the organ. Many patients have a legitimate interest in the procedure, so we will try to answer such questions: what is this diagnostic method, what are the consequences after a prostate biopsy and whether there are contraindications.
Introduction to the topic
According to the materials of the site ahealthyman.com the essence of the biopsy consists in taking the material under study (cells, tissues), the structure of which is studied under special microscopes. There are 2 types of biopsy:
The histological method is carried out using optical medical equipment. The seized material is placed in a special solution, it is first processed. With the help of a cutting tool (microtome), the tissue under study is cut into thin parts with a thickness of no more than 3 micrometers. Then the pathologist places it on laboratory glasses, degreases the fabric with alcohol solutions, paints it in various dyes.
Staining makes it possible to examine the structure of the cellular apparatus under a microscope, the presence of a mutation.
The cytology method has its differences. When using it, cells are studied directly, and not the tissue structure of the organ. If pathological deformations occur inside the cell, the morphologist will see this process under the magnifying glasses of the cytology apparatus. To date, this study is less accurate than histology.
For a prostate biopsy, a prostate puncture is taken. If the presence of malignant processes in the organ is suspected, a polypocal biopsy is often used.
During this diagnosis, a thin long needle – a resectoscope is inserted into the urinary canal of a man. A clamp is placed on the outside, which is used to capture the material under study.
A cytoscope is also used. This instrument is a flexible cord, which is called a probe. On one side there is a light bulb, which, when inserted inside, illuminates the visible area, outside the device is equipped with a magnifying mirror similar to a microscope. A thin scalpel (cutting loop) is placed near the lamp, with which it performs tissue resection.
Transurethral prostate biopsy is painful. The patient cannot withstand the procedure without the use of painkillers. As a rule, local anesthesia is used, local anesthesia is achieved by introducing drugs into the spinal canal that completely block the transmission of nerve impulses for a while.
During the procedure, the patient is in a supine position, on his back. The duration is no more than 30 minutes. The taken material is sent to the laboratory for research. Histological examination of the tissue in this case provides information about the functioning of not only the prostate, but also the bladder, makes it possible to identify the course of concomitant diseases at the preclinical stage.
After a transurethral prostate biopsy, a man may experience mild discomfort, pain is relieved by nonsteroidal drugs.
This type of biopsy is rarely used. Its use is due to the need for a large number of biomaterial sampling points. Most often, he is approached in cases when additional studies on oncologyprostates do not give an unambiguous answer.
Before the biopsy, local anesthesia is performed. The specialist makes a small incision in the perineum, inserts a finger into the rectum and presses the prostate. A needle is inserted into the incised area and slowly scrolled through it in order to carry out tissue sampling.
This allows you to take material from different sites and get a more informative result. It takes about 15 minutes on average.
After a prostate biopsy, the patient is shown to rest, it is necessary to treat the incision site with disinfectants to prevent the development of infection.
Other types of biopsy
Transrectal biopsy of prostate tissues (rectal examination) is a complex multifocal biopsy of the study of prostate tissue. The essence is to use a sensitive rectal sensor and an ultrasound machine.
The instrument is placed in the rectum, ultrasound waves help to accurately direct the probe to the prostate. It is a less painful method of examination, as well as less traumatic compared to other types of biopsy. Sometimes local analgesics are used in order to alleviate the discomfort that occurs when penetrating the anus. The procedure lasts half an hour, allows sampling up to 12 fragments of histological material.
Saturation biopsy of the prostate gland is not used as a primary method of investigation. Its use is indicated in cases of persistent persistence of suspicion of an oncological process in the organ.
With such diagnostics, the range of tissue sampling increases, the material can be taken from 20 points. This type of biopsy allows you to accurately assess the degree of degenerative processes, to identify pathomorphological characteristics. The use is indicated in the presence of atypical prostatic hyperplasia. Conducting a biopsy of a surgical character is advisable with hyperactive growth of benign formations (prostate adenomas).
After a prostate biopsy of this type, the patient needs rest, rest. It is necessary to avoid physical exertion.
Indications for emergency hospitalization and surgical intervention require rapid diagnostic methods. In such cases, hypersensitive histological devices are used. The material under study goes through several stages of processing:
- hardware fixation;
- automatic cutting;
- full water intake (dehydration);
- treatment with ethyl alcohol;
- impregnation in paraffin preparations;
- application of different colors of dyes.
Such instruments are equipped with a screen and special computer programs, a laboratory technician can modify the settings and obtain additional data during histological examination.
Automatic screening analyzers make it possible to get an accurate result in a short time. This is of fundamental importance, since the organ tissue that is taken for diagnosis should not be in the laboratory for a long time, its use period is limited.
The latest generation tools have an uninterruptible power supply. Even in the absence of electricity supply, it is possible to perform an analysis. The batteries are made of environmentally friendly, fire-fighting materials. The accuracy of data using such tools exceeds the results of similar studies performed in a different way.
Recently, a “liquid biopsy” is often used. This method makes it possible to detect genetic mutations in prostate tissues in the early stages. Diagnostics is aimed at identifying cancer cells and studying their DNA. The devices that are used in this type of research study not the tissue structure itself, but foreign genetic elements circulating in the body. With the help of a “liquid biopsy”, it is possible to determine the disease long before the clinical signs.
A prostate biopsy is an extreme diagnostic method that is most often used in the study of oncological diseases. Indications for carrying out can be:
- an increase in the level of tumor oncomarker in the blood (prostate specific antigen);
- seals of various shapes detected during rectal examination of the prostate;
- the presence of atypical zones during transrectal ultrasound examination;
- the growth of leukocytes in the prostate secret;
- prolonged, recurrent inflammatory processes;
- constant prostate pain syndrome of unclear etiology;
- bloody discharge from the genitals in the absence of bladder pathologies, urogenital infections;
- difficulty urinating of idiopathic nature;
- sudden weight loss, general intoxication;
- subfebrile temperature, constant fatigue, asthenia, apathy against the background of chronic prostatitis;
- high-grade prostate pin (intraepithelial neoplasia of an organ with a large number of atypical cells).
Subsequent biopsy and histology of the prostate are used after radiation and chemotherapy. It makes it possible to evaluate the therapeutic effect, the general prognosis of the disease, and further treatment tactics.
In recent years, medical statistics have provided disappointing data on the spread of prostate cancer. In the United States, more than 1 million cases of prostatitis are diagnosed annually, which over the next 10 years is transformed into a malignant tumor. In the countries of Western and eastern Europe, prostate cancer occupies the 3rd place.
Cancer begins to develop from healthy cells by a modified mutation. From the point of view of evolution, mutational processes are necessary for the human body, thanks to them, a person learns to adapt to changing environmental conditions and retains, at the same time, a state of homeostasis.
The development of an oncological cell begins with a pathological change in the genome of the cell, several nuclei and shells appear in it, the process of division becomes uncontrolled. A malignant tumor absorbs a significant amount of nutrients, their deficiency occurs, which affects the work of other organs. A person begins to lose weight rapidly for no apparent reason.