(Transrectal Biopsy; Transurethral Biopsy; Transperineal Biopsy)
A prostate biopsy is the removal of a small amount of tissue from the prostate gland. The tissue is examined for the presence of cancer cells.
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Reasons for Procedure
A prostate biopsy is usually done after an abnormal finding by:
- Digital rectal exam
- Prostate specific antigen (PSA) blood test
A prostate biopsy is the only way to find out if cancer cells are present.
Problems from the procedure may occur, but all procedures have some risk. Your doctor will review potential problems, like:
- Bruising or lengthy bleeding from the rectum, or in urine or semen
- Difficulty urinating
- Reactions to anesthesia
Factors that may increase the risk of complications include:
- History of bleeding disorders or easy bruising
- Use of any medications, over-the-counter medications, or herbal supplements
- Sensitivity or allergy to latex, medications, or anesthesia
What to Expect
Prior to Procedure
You may be asked to do the following:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Begin taking an antibiotic.
- Use an enema several hours before the procedure.
- If you will be getting general anesthesia, do not eat or drink anything after midnight.
The type of anesthesia depends on the method that your doctor uses:
Transurethral biopsy and perineal biopsy:
- General anesthesia —Blocks pain and keeps you asleep through the surgery. This will be used for a transrectal prostate biopsy.
- Local anesthesia—Just the area that is being operated on is numbed, given as an injection and may also be given with a sedative.
Description of the Procedure
Your doctor will use one of the following methods to do the biopsy:
- Transrectal biopsy (most common method)—Your doctor will insert a small ultrasound device into the rectum. This device will produce sound waves to create an image of the prostate. These images will help guide placement of the needle. Your doctor will then insert the needle through the wall of the rectum and into the prostate gland.
- Transurethral biopsy—Your doctor will insert a lighted flexible tube through the tip of the penis and into the urethra. The urethra carries urine from the bladder. Your doctor will get the biopsy with a cutting loop that is passed through the flexible tube.
- Perineal biopsy—Your doctor will make a small incision in the perineum. The perineum is the area between the scrotum and the rectum. The doctor will insert a small needle into the prostate gland to get the biopsy.
How Long Will It Take?
About 30 minutes
Will It Hurt?
You may have discomfort and soreness at the biopsy site. Pain and discomfort after the procedure can be managed with medications.
Blood in the urine, stool, or semen is normal. This may last several days. You may be advised to avoid strenuous activity a day or two after the procedure. Follow your doctor's instructions on caring for the biopsy site.
After the sample is taken, it will be sent to a pathologist for examination under a microscope. If cancer is present, your doctor will work with you to develop a treatment plan.
Call Your Doctor
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Inability to urinate
- Blood in the urine more than 2-3 days post-biopsy
- Signs of infection, including fever and chills
- Pain that you cannot control with the medications you have been given
- Pain, burning, urgency, or frequency of urination
- Cough, shortness of breath, or chest pain
- Rectal bleeding that lasts more than 2-3 days after the biopsy
If you think you have an emergency, call for emergency medical services right away.
National Cancer Institute
Urology Care Foundation
Prostate Cancer Canada
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Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 7/13/2016