Should I have a general or local anaesthetic for a biopsy?
The first question is whether you need a biopsy at all. Generally, trying to avoid having a biopsy is a good idea, if possible.
- That’s because biopsies are invasive procedures.
- They also increase the chance that we’ll find microscopic cancers that don’t need treatment but cause anxiety and stress.
- If you have a high-quality MRI which doesn’t show a lesion, you often don’t need a biopsy (clinicians sometimes need to conduct biopsies because they don’t trust the results of the MRI).
Traditional biopsies:
- Are conducted by sticking a biopsy needle through the rectal wall into the prostate and taking 6 biopsies from each side, giving you 12 random biopsies.
- Are less popular now because they offer limited localisation, the risk of under-sampling and the risk of infection as the needles may pass through faecal matter.
A state-of-the-art biopsy technique is MRI fusion guided transperineal biopsy:
- This samples prostate tissue via the perineum (skin between scrotum and anus) using a needle, guided by ultrasound.
- That means there’s less chance of infection.
- Transrectal ultrasound images guide the needle into the area where the MRI says there’s a problem (MRI fusion), so we’re more focused on the tissue we’re sampling.
Biopsies are conducted by some clinics using a local anaesthetic. We always use a general anaesthetic for your comfort and so that you don’t move during this delicate and invasive procedure.
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