Before your surgery, your doctor may order some tests and do some examinations
- If you have symptoms, a digital rectal examination can help your doctor locate abnormalities in your prostate.
- Your urologist may use an ultrasound to help them decide which approach is best for you.
- The prostate specific antigen test (PSA) is a blood test that can identify prostate abnormalities. Your urologist will take into account your age, a urinary tract infection or prostate disease, recent diagnostic procedures and the treatments you’re currently having when interpreting the results. This is a controversial test as an increased PSA can have multiple causes. Learn about prostate screening.
- A CT and/or MRI scan can help your urologist decide whether surgery is the best approach. It can also help your surgeon plan your biopsy. An MRI can also detect secondary cancers.
- Cystoscopy (examination of the bladder and urethra with a camera) can also help to plan the approach.
- Your urologist may suggest having a prostate biopsy to determine if you have prostate cancer. This is usually done in hospital, but will sometimes be done in the doctor’s rooms.
The procedure may be performed through your rectum (under IV sedation) or through the skin between your scrotum and anus (under general anaesthetic). You’ll be given an antibiotic either just before or during the procedure.
The doctor takes needle biopsy samples of the prostate tissue. Afterwards you may experience some tenderness, blood in urine and ejaculation, and rarely, infection or difficulty passing urine. The biopsy will help to determine the grade of the cancer. Learn more about cancer grades.
If you currently have a urinary tract infection or blood in your urine, your doctor will want to treat these problems before surgery.
You should tell your doctor about any existing health problems and medications you’re taking. Ask if you should stop any medications before surgery, such as blood thinners (anticoagulants).
Your doctor may ask you to have a ‘bowel prep’ before surgery. This involves taking medications the day before surgery to clear out your bowel. Bowel prep usually causes diarrhoea so you’ll need to stay close to your bathroom and expect some discomfort and urgency.