Concierge urology imaging · London
Prostate cancer prostate mapping, systematic 3D grid biopsy for accurate cancer staging and focal-therapy planning.
Prostate mapping is a systematic 3D grid transperineal biopsy — 30–50 cores at 5 mm intervals — used to accurately locate prostate cancer for focal therapy planning, active surveillance decisions and equivocal PSA / mpMRI cases.
Key facts
- 01
Definition
A systematic 3D-grid transperineal prostate biopsy that maps the whole gland.
- 02
Anaesthetic
Performed under general anaesthetic in a day-case theatre.
- 03
Sampling density
30–50 cores taken at 5 mm intervals across the prostate volume.
- 04
Focal therapy foundation
The reference biopsy for planning HIFU, cryotherapy or electroporation.
- 05
Complements mpMRI
Confirms and localises what multiparametric MRI can only suggest.
- 06
Same-day discharge
Home the same day, back to desk-based work within 48–72 hours.
The problem
Standard biopsy misses too much, mpMRI can’t confirm it.
Prostate mapping bridges the gap — 30–50 cores at 5 mm spacing give the per-location Gleason grade needed to plan focal therapy, decide on active surveillance, or resolve equivocal PSA / mpMRI findings.
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Equivocal PSA / mpMRI?
When imaging is suggestive but not conclusive, mapping tells you what is actually there.
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Considering focal therapy?
Focal HIFU or cryotherapy needs a mapped tumour — this is the reference biopsy.
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Active surveillance decision?
Mapping confirms unifocal, low-grade disease before committing to surveillance.
The pathway
From urology consultation to MDT plan — what happens, in order.
One coordinated pathway from first consultation to a written MDT-agreed plan.
Phase 1 · Before the biopsy
Consultation, imaging, pre-assessment
Phase 2 · Day-case theatre
GA, 30–50 cores, home same day
Phase 3 · Pathology and plan
Per-core mapping, MDT, written plan
- 01
Before
Urology consultation
A consultant urologist reviews your PSA trend, symptoms, prior biopsies and family history — and confirms mapping is the right next step.
- 02
Before
mpMRI review
Your multiparametric MRI is re-read by a uro-radiologist and PI-RADS lesions are marked onto the mapping template.
- 03
Before
General anaesthetic assessment
Anaesthetic pre-assessment, medication review (particularly anticoagulants) and consent for day-case surgery.
- 04
On the day
Transperineal 3D-grid biopsy
Under general anaesthetic, 30–50 cores are taken at 5 mm intervals through a perineal grid — mapping the whole gland.
- 05
After
Pathology mapping
Each core is reported individually — per-core Gleason grade, cancer length and location plotted onto a 3D map.
- 06
After
MDT review
Urology, radiology and pathology discuss your case at a multi-disciplinary team meeting.
- 07
After
Focal therapy or surveillance plan
A written plan — active surveillance, focal therapy, or radical treatment — with the reasoning laid out.
Typical end-to-end: 3–5 weeks, including pathology and MDT.
What it shows
The eight things prostate mapping answers.
A per-core, per-location picture of the prostate — grade, length, laterality and focal-therapy candidacy — with the red flag that changes the plan.
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Per-core Gleason grade
Every core is graded individually — the foundation of accurate staging.
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Per-core cancer length
Millimetres of cancer per core — a direct proxy for tumour volume.
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Anterior tumour detection
Reaches the anterior zone that transrectal biopsy routinely misses.
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Bilateral disease
Confirms whether cancer is unilateral (focal-therapy candidate) or bilateral.
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Tumour volume estimation
The 3D grid gives a defensible estimate of total cancer volume.
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Radiological–pathological concordance
Checks whether mpMRI lesions match the pathological findings on biopsy.
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Suitability for focal therapy
The reference test for deciding if HIFU, cryotherapy or electroporation is appropriate.
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Red flag: unexpected Gleason 8+ — urgent MDT
Any Gleason 4+4 or above triggers same-week MDT review and radical-treatment counselling.
Treatment options
What a mapped prostate unlocks.
Once you have a per-core map, the whole treatment ladder is on the table — from active surveillance to whole-gland radical treatment.
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Active surveillance
For unifocal, low-grade disease (Gleason 3+3, low-volume 3+4) — structured PSA, MRI and repeat biopsy.
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Focal HIFU
High-intensity focused ultrasound targeted at the mapped tumour, preserving surrounding gland.
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Focal cryotherapy
Focal freezing of the tumour zone — an alternative energy source with similar sparing intent.
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Focal electroporation
NanoKnife irreversible electroporation — non-thermal ablation near neurovascular bundles.
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Radical prostatectomy
Robotic-assisted removal of the whole prostate — for higher-grade or higher-volume disease.
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External beam radiotherapy
IMRT or SBRT to the whole gland, sometimes with androgen deprivation.
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Structured urology follow-up
Scheduled PSA, imaging and clinical review — whatever pathway you choose.
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Multi-disciplinary review
Every mapped case is discussed at MDT — urology, radiology, pathology, oncology.
Our vetted London network
A small panel of urology teams, we picked them.
Partners across central London — high-volume template biopsy operators paired with dedicated uro-radiology and uro-pathology.
Selection criteria
How we choose every team in our network.
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Consultant urologists sub-specialised in transperineal template biopsy
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Uro-radiologists reporting mpMRI to PI-RADS v2.1
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Dedicated uro-pathology reporting with per-core Gleason mapping
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Onward MDT and focal-therapy pathway if suitable disease is found
Red flags
The findings and events that change the plan.
Prostate mapping is safer than transrectal biopsy, but there are situations — pathological and post-procedural — that need urgent action.
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Unexpected Gleason 8+
Any Gleason 4+4 or higher on any core triggers same-week MDT and radical-treatment counselling.
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Bilateral high-volume disease
Cancer in both lobes at significant volume moves the case out of focal-therapy territory.
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Extraprostatic extension
Disease reaching the capsule or beyond changes staging and treatment intent.
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Post-mapping sepsis
Fever, rigors or unwell within 72 hours — call the on-call urology team or 999.
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Post-mapping urinary retention
Inability to pass urine after catheter removal — return to A&E for re-catheterisation.
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Post-mapping rectal injury
Rare with the transperineal route, but rectal bleeding needs same-day review.
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Anaesthetic complication
Chest pain, breathlessness or a new arrhythmia after general anaesthetic — 999.
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Rising PSA post-mapping
A sustained PSA rise despite a negative mapping is a repeat-imaging trigger.
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Discordant mpMRI–pathology finding
When imaging and biopsy disagree, the MDT decides on repeat imaging or targeted re-biopsy.
Reading your report
A mapping pathology report looks intimidating. It isn’t.
Every mapping report keeps to the same four parts, with a 3D map plotting per-core findings.
A quiet reminder
The report is written for the MDT, not for you — and that’s normal.
If you would like us to talk you through the map before your MDT feedback, just ask.
- 01 Header
Indication and prior imaging
PSA trend, prior biopsies, mpMRI PI-RADS lesions and the reason mapping was chosen.
- 02 Technique
Grid, cores and anaesthetic
Number of cores, grid spacing, anatomical zones sampled and anaesthetic used.
- 03 Findings
Per-core Gleason, length, location
Each core reported individually and plotted onto a 3D map of the prostate.
- 04 Impression
Focal-therapy candidacy and MDT plan
The bottom line — surveillance, focal, or radical — with the MDT-agreed next step.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about prostate mapping.
Quick answers on what mapping is, how it differs from a standard biopsy, anaesthetic, recovery, risks and treatment decisions.
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What is prostate mapping?
Prostate mapping is a systematic 3D-grid transperineal biopsy — 30–50 cores taken at 5 mm intervals across the whole gland under general anaesthetic. It gives a per-core, per-location picture of cancer that a standard biopsy cannot.
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How is it different from a standard prostate biopsy?
A standard transperineal or transrectal biopsy takes 12–20 targeted or systematic cores. Mapping takes 30–50 cores through a rigid grid at 5 mm spacing — the sampling density needed to plan focal therapy or to make confident active-surveillance decisions.
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Do I need a general anaesthetic?
Yes. The number of cores and the grid technique make general anaesthetic the standard of care. You come in as a day case and go home the same day once you have passed urine.
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What happens after the biopsy?
Same-day discharge once you have passed urine. Expect bruising, blood in the urine or semen for a few weeks, and desk-based work within 48–72 hours. Full pathology and MDT review typically takes 10–14 days.
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What are the risks?
The main risks are urinary retention (5–10%), infection (lower than transrectal biopsy but not zero), transient erectile changes, and haematuria or haematospermia that can last weeks. Rectal injury and sepsis are rare via the transperineal route.
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When would I need focal therapy versus active surveillance?
Unifocal, low-grade, low-volume disease often stays on active surveillance. Localised, mapped tumours that are clinically significant (Gleason 3+4 or 4+3, contained, unilateral) are the typical focal-therapy candidates. Higher grade or bilateral disease usually needs whole-gland treatment. The MDT decides.
Sources
Clinical guidance behind this page.
- NICE. Prostate cancer: diagnosis and management (NG131).
- European Association of Urology. Guidelines on prostate cancer.
- British Association of Urological Surgeons. Prostate cancer resources.
- Focal Therapy Society. Consensus and guidance on focal therapy.
Last reviewed 2026-07-30. Next review 2027-07-30. Reading time ~6 min.
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In practice, in London
The London pathway for prostate cancer prostate mapping
With prostate cancer prostate mapping, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for prostate cancer prostate mapping vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
A private prostate cancer prostate mapping pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For prostate cancer prostate mapping specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
The value of going through a concierge for prostate cancer prostate mapping isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.