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A prostate biopsy is a procedure used to remove a small piece of tissue or cells from the body so it can be examined under a microscope. 

In a prostate biopsy, prostate gland tissue is taken out with a biopsy needle or during surgery. The tissue is checked to see if there are cancer or other abnormal cells in the prostate gland. 

A prostate biopsy may be done in several different ways: 

  • Transrectal method. This is done through the rectum and is the most common.
  • Perineal method. This is done through the skin between the scrotum and the rectum.
  • Transurethral method. This is done through the urethra using a cystoscope (a flexible tube and viewing device). 

Ultrasound is usually used to look at the prostate gland and guide the biopsy needle. 

INDICATIONS FOR PROSTATE BIOPSY

  • Initially, patients with a prostate-specific antigen (PSA) value higher than 4.0 ng/mL were believed to have an absolute indication.
  • Biopsy typically was also recommended for patients with suspicious findings on digital rectal examination (DRE). 

However, the current established practice is that no PSA value exists that can establish with absolute certainty whether a patient does or does not have prostate cancer. Thus, the decision whether to proceed with prostate biopsy must be individualized in every case. 

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