Prostate Biopsy: A Patient Guide

When a man has an elevated PSA or an abnormal prostate exam, the next step in finding answers is often a prostate biopsy. For many patients, the word “biopsy” raises concern—but today’s technology makes the procedure safer, more precise, and more informative than ever before.

At Advanced Urology, we perform transperineal prostate biopsy using the latest 3D surgical navigation technology from Koelis. This approach provides superior cancer detection, avoids the risk of infection associated with older methods, and allows us to combine biopsy results with advanced genetic testing from MDxHealth to give patients the most accurate and personalized information about their prostate health.

What Is a Prostate Biopsy?

A prostate biopsy is a procedure where small samples of tissue are taken from the prostate gland and examined under a microscope to check for cancer cells.

Traditionally, biopsies have been done through the rectum (transrectal approach), where a needle passes through rectal tissue into the prostate. While effective, this method carries a small but real risk of serious infection, since bacteria from the rectum can be introduced into the prostate and bloodstream.

Why Transperineal Biopsy Is Better

At Advanced Urology, we exclusively perform transperineal prostate biopsy. In this approach, the biopsy needle passes through the skin between the scrotum and rectum (the perineum), instead of through the rectum.

Advantages of transperineal biopsy include:

  • No risk of infection: Because the needle doesn’t pass through the rectum, the risk of sepsis or severe infection is virtually eliminated.
  • More accurate sampling: Transperineal access provides better coverage of all regions of the prostate, especially the anterior zones that are often under-sampled with transrectal biopsies.
  • Improved cancer detection: Studies show that transperineal biopsy increases the likelihood of detecting clinically significant prostate cancers while reducing detection of insignificant, low-risk cancers.
  • Safer and more comfortable: With modern anesthesia and technique, the procedure is quick, well tolerated, and highly safe.

Koelis 3D Surgical Navigation Technology

Precision matters in prostate biopsy. At Advanced Urology, we use the Koelis Trinity system, one of the most advanced platforms for targeted prostate biopsy.

  • 3D mapping: Koelis builds a detailed three-dimensional model of the patient’s prostate.
  • MRI fusion: If a prostate MRI has identified suspicious lesions, Koelis software fuses the MRI with real-time ultrasound to guide the biopsy needle exactly to the right spot.
  • Navigation and tracking: Each biopsy core is recorded and mapped within the 3D model, so we know exactly where tissue samples were taken.

This technology ensures that no areas are missed and allows for precise follow-up if additional biopsies are ever needed. It represents the gold standard for accuracy in prostate cancer diagnosis.

Beyond the Biopsy: Genetic Testing with MDxHealth

A biopsy doesn’t just tell us if cancer is present—it can also help us understand how aggressive it is likely to be. To go even deeper, Advanced Urology partners with MDxHealth, a leader in molecular diagnostics.

  • DNA-based analysis: MDxHealth tools look at the genetic characteristics of biopsy tissue to assess how likely a cancer is to grow or spread.
  • Personalized risk profile: This genetic information adds another layer of precision to traditional pathology, helping doctors and patients make more informed decisions.
  • Tailored treatment planning: With MDxHealth results, we can recommend surveillance, surgery, radiation, or other therapies with greater confidence, matching the treatment to the biology of each man’s cancer.

What to Expect During a Transperineal Biopsy

  1. Preparation: Patients are usually given anesthesia for comfort. Unlike transrectal biopsy, there is no need for antibiotics since infection risk is minimal.
  2. Imaging: Real-time ultrasound, often fused with MRI images, is used to guide the biopsy.
  3. Sampling: A specialized device passes tiny needles through the perineal skin into the prostate, collecting small tissue samples.
  4. Recovery: The procedure typically takes less than an hour. Most patients go home the same day with minimal discomfort. Blood in the urine or semen is common for a few days, but serious complications are extremely rare.

Why Choose Advanced Urology for Prostate Biopsy?

  • Safer approach: We perform only transperineal biopsies, eliminating infection risk.
  • Cutting-edge technology: With Koelis 3D navigation and MRI fusion, we achieve unmatched precision in prostate cancer detection.
  • Genetic insight: Our partnership with MDxHealth allows us to evaluate the DNA of biopsy tissue, giving patients advanced information beyond standard pathology.
  • State-of-the-art ASCs: Procedures are performed in our modern ambulatory surgery centers, ensuring safety, comfort, and same-day discharge.
  • Expert team: Our fellowship-trained urologists are among the most experienced in performing advanced prostate biopsies.

Conclusion

A prostate biopsy is an important step in understanding prostate health and detecting cancer early. At Advanced Urology, we use the safest and most advanced methods available: transperineal biopsy with Koelis 3D navigation technology, combined with MDxHealth genetic testing. This ensures not only accurate diagnosis but also personalized insight into the biology of each man’s prostate cancer.

With our expertise, technology, and commitment to patient comfort, men can feel confident that they are receiving world-class prostate cancer evaluation in a safe, state-of-the-art environment.

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