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Table 2 Summary of information that men suggested should be added to patient information leaflets

From: Role of information in preparing men for transrectal ultrasound guided prostate biopsy: a qualitative study embedded in the ProtecT trial

Topic Additional information suggested
-Intensity Some men report experiencing intense pain and/or distress during biopsy.
-Duration Pain and soreness may last up to 4–6 weeks after biopsy.
-Site of bleeding There may be considerable blood loss immediately following biopsy from the penis, in the semen, urine and from the back passage.
-Quantity of blood loss The amount of blood in the semen, urine and back passage may appear enough to mask the semen/urine/faeces.
-Duration of bleeding Bleeding may last (or occur intermittently) for 5 weeks after biopsy.
-Stop/start bleeding Bleeding may stop after a fortnight, and then restart e.g. a week later.
-Appearance of blood Blood may appear red or black in colour, may appear as clots or solid lumps or as fluid.
Biopsy procedures
−10-12 cores taken Normally between 10 and 12 biopsy samples will be taken and each sample requires the needle to be fired into the prostate
-Anaesthetic Men will be given a local anaesthetic, injected into the prostate. Occasionally, men feel faint after biopsy and this is why men are asked to bring someone to drive them home afterwards.
-Staff present Biopsy will be carried out by an urologist, radiologist or specialist nurse and a nurse will also be present. Male and female members of staff may be present.
Fear of cancer spread No evidence has been found that biopsy can result in cancer spreading more quickly.
Fear of hospital acquired infection The risk of hospital acquired infection is:
• Colonisation with MRSA (0.9% - 1 in 110)
• Clostridium difficile bowel infection (0.01% - 1 in 10,000)
• MRSA bloodstream infection (0.02% - 1 in 5000)
  1. Other comments from men:
  2. Men who felt well-prepared, reported that health professionals had talked through the procedure with them before biopsy.
  3. Men who had undergone previous invasive medical procedures felt less concern about biopsy than those who had not.