Prostate Biopsy
(Transrectal Biopsy; Transurethral Biopsy; Transperineal Biopsy)
Definition
A prostate biopsy is removal of a tissue from the prostate gland. The prostate is a small, walnut-shaped gland in men. The removed tissue is sent for testing.
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Reasons for Procedure TOP
A prostate biopsy is done if part of the prostate looks suspicious. It is often done after abnormal results from:
- Digital rectal exam
- Prostate specific antigen (PSA) blood test
A prostate biopsy is the only way to find out if there are cancer cells.
Possible Complications TOP
Problems from the procedure may occur, but all procedures have some risk. Your doctor will review potential problems, like:
- Infection
- Bruising or bleeding from the rectum
- Blood in urine or semen
- Problems passing urine
- Reactions to anesthesia
Things that may increase the risk of problems include:
- Smoking
- History of bleeding disorders or easy bruising
- Use of any medicine including, over the counter medicine, or supplements
- Sensitivity or allergy to latex, medicine, or anesthesia
What to Expect TOP
Prior to Procedure
You may be asked to:
- Make a urine sample. It will be checked for infection in the urinary tract. The biopsy may be delayed if an infection is present.
- Stop taking some medicine and supplements for several days before the biopsy.
- Do an enema at home to clean out the bowel.
- Take antibiotics 30 to 60 minutes before the biopsy. It will help to prevent an infection.
Anesthesia
The type of anesthesia will be based on type of procedure. It may be one of the following:
- General anesthesia—blocks pain and keeps you asleep through the surgery
- Local anesthesia—just the area is numbed; it may also be given with a sedative to help you relax
Description of the Procedure TOP
There are different types of surgery. The choice is made based on your health goals and where the growth is. Choices include:
- Transrectal biopsy (most common method)—A needle is sent through the rectum wall into the prostate. It will draw out a sample of tissue. A small ultrasound wand will be placed in the rectum. It will help to guide the needle.
- Transurethral biopsy—A flexible tube is passed through the tip of the penis. It will be passed up through the tube to where the prostate sits. A cutting loop will be passed through the tube. It will remove a section of prostate.
- Perineal biopsy—A small incision will be made in the area between the scrotum and the rectum. A small needle will be passed through the cut into the prostate gland. A sample will be drawn out with the needle.
How Long Will It Take? TOP
About 30 minutes
Will It Hurt? TOP
You may be sore at the site. Pain and discomfort after the procedure can be managed with medicine.
Postoperative Care TOP
Some activity will need to be avoided for 1 to 2 days.
The sample will be examined under a microscope. The doctor will follow up on the results.
Call Your Doctor TOP
Call your doctor if any of these occur:
- Cannot pass urine
- Blood in the urine more than 2 to 3 days after the biopsy
- Signs of infection, including fever and chills
- Pain that you cannot control with the medicine you have been given
- Pain, burning when you pass urine or peeing more often and having intense urges
- Cough, shortness of breath, or chest pain
- Rectal bleeding that lasts more than 2 to 3 days after the biopsy
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
National Cancer Institute
https://www.cancer.gov
Urology Care Foundation
http://www.urologyhealth.org
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
Prostate Cancer Canada
http://www.prostatecancer.ca
REFERENCES:
Prostate biopsy. EBSCO DynaMed website. Available at: https://www.dynamed.com/evaluation/prostate-biopsy. Updated August 6, 2019. Accessed January 8, 2020.
Rodriguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol. 1998;160(6-I):2115-2120.
Tests for prostate cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/how-diagnosed.html. Updated May 15, 2017. Accessed January 8, 2020.
Tiong HY, Liew LC, Samuel M, Consigliere D, Esuvaranathan K. A meta-analysis of local anesthesia for transrectal ultrasound-guided biopsy of the prostate. Prostate Cancer Prostatic Dis. 2007;10(2):127-136.
Understanding prostate changes: A health guide for men. National Cancer Institute, National Institutes of Health website. Available at: https://www.cancer.gov/types/prostate/understanding-prostate-changes. Accessed January 8, 2020.
6/2/2011 DynaMed Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
7/13/2016 DynaMed Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905693/Prostate-biopsy: Gershman B, Van Houten HK, Herrin J, et al. Impact of prostate-specific antigen (PSA) screening trials and revised PSA screening guidelines on rates of prostate biopsy and postbiopsy complications. Eur Urol. [Epub ahead of print] 2016 Mar 16.
Last reviewed September 2019 by
EBSCO Medical Review Board
Nicole Meregian, PA
Last Updated: 9/25/2020