Your urologist has recommended you for a template biopsy of your prostate. This type of biopsy uses a grid (template), with tissue samples extracted through holes in the grid. Each hole correlates to numbers and letters, not dissimilar to a map grid. This means tissue samples can be taken from the prostate in a very precise and specific way.
You may have already had standard biopsies and your urologist requires further, more precise biopsies.
Why a template biopsy?
A template biopsy is the not the only type of biopsy we use. You may have had, or have been offered, a TRUS biopsy (trans-rectal ultrasound guided). This is the standard prostate biopsy, which involves inserting a probe via the rectum and collecting needle samples via the probe.
The TRUS biopsy can sometimes be inconclusive. It collects fewer tissue samples than the template biopsy (usually 12) achieving a far lower overall level of accuracy. It is carried out under local anaesthetic and some patients find the TRUS procedure uncomfortable and in some cases, painful.
If the result of the TRUS biopsy is negative, but there is a high suspicion that there may be cancer present, a template biopsy will offered.
Template biopsy and the way we assess prostate cancer
The template biopsy delivers a much higher level of precision. We only proceed to biopsy once the following assessments have taken place:
- The standard PSA (Prostate Specific Antigen)
- DRE (Digital Rectal Examination)
- Enhanced prostate MRI.
Therefore, we only proceed to biopsy at a stage when there is a strong indication that cancer is present in the prostate.
Consequently, we require a biopsy which is highly accurate and is much less likely to deliver false negatives.
Types of template biopsy
There are broadly two different types of template biopsy: a saturation template biopsy and a targeted template biopsy. The type used depends on the intention of the procedure.
- A targeted template biopsy is used if the intention is to focus on one part of the prostate (usually identified on MRI) this will give the urologist more information prior to commencing treatment.
- A saturation template biopsy is used if the intention is to assess the whole of the prostate, mapping every part, taking up to 50 tissue samples.
Having a template biopsy: what to expect
We always carry out template biopsies under a general anaesthetic (GA). This means that you won’t be able to drive for 48 hours, so you will need someone to drive you home from hospital or make some arrangements for transport home. You will also need to ensure that somebody stays with you overnight following the procedure.
Once you are asleep, a catheter is inserted to show exactly where the urethra is (the tube that carries urine from the bladder to the penis) and this ensures the urologist avoids placing any needles in the urethra.
The urologist is guided by the images from your MRI scan which is mapped against the prostate. Between 20 to 50 needle samples are taken (the number depending on whether you are having a saturation biopsy, which uses a higher number, or a targeted biopsy, the lower number). After all the tissue samples have been taken, the catheter is removed.
The template biopsy procedure takes approximately 20 minutes.
When will I receive the results of my template biopsy?
You will receive an appointment to come into clinic to discuss your results with your Urologist about two to three weeks after your procedure. They will explain the results of your template biopsy, what they mean in terms of management and treatment options and all other considerations.