Prostate Biopsy

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A prostate gland biopsy is a test to remove small samples of prostatetissue to be examined under a microscope. For a prostate biopsy, a thin needle is inserted through the rectum(transrectal biopsy), through the urethra, or through the area between theanus and scrotum (perineum). A transrectal biopsy is the most common method used. The tissue samples taken during the biopsy are examined for cancer cells. A biopsy may be done when a blood test shows a high level of prostate-specific antigen (PSA) or after a digital rectal examination finds an abnormal prostate or a lump.

Why It Is Done

A prostate biopsy is done to determine:

If a lump found in the prostate gland is cancer.
The cause of a high level of prostate-specific antigen (PSA) in theblood.

How To Prepare

Tell your doctor if you:

Have had any bleeding problems.
Are allergic to latex or any medicines, including anesthetics.
Take any medicines regularly. Be sure your doctor knows the names and doses of all your medicines.
Are taking any blood-thinning medicines, such as warfarin(Coumadin), heparin, enoxaparin (Lovenox), aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs).

You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have regarding the need for the biopsy, its risks, how it will be done, or what the results will mean. To help you understand the importance of the biopsy, fill out the medical test information form(What is a PDF document?).

If a prostate biopsy is done under local anesthesia through the area between the anus and scrotum (perineum), no other special preparation is needed.

If the biopsy is done through the rectum, you may need to have an enemabefore the biopsy.

If the biopsy is done under general anesthesia, your doctor will tell you how soon before surgery to stop eating and drinking. Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of the surgery, please do so using only a sip of water.

During preparation for the biopsy, an intravenous line (IV) is inserted in your arm, and a sedative medicine is given about an hour before the biopsy.

How It Is Done

This biopsy is done by a doctor who specializes in men's genital and urinary problems (urologist) in the doctor's office, a day surgery clinic, or a hospital operating room.

Before your prostate biopsy, you may be given antibiotics to prevent infection. You may be asked to take off all of your clothes and put on a hospital gown.

Transrectal ultrasound (TRUS) is commonly used to guide the placement of the needle during a prostate biopsy.

How It Feels

You may feel a slight sting when you receive an injection of medicine to numb your skin. You may feel a dull pressure as the biopsy needle is inserted. For a transrectal biopsy, you may feel pressure in the rectum while the ultrasound probe or guiding finger is in place. You also may feel a brief, sharp pain as the biopsy needle is inserted into the prostate gland. Usually several biopsy samples are collected.

Following the biopsy, you will be asked to avoid strenuous activities for about 4 hours. You may have mild pain in the pelvic area and blood in your urine for up to 5 days. Also, you may have some discoloration of your semen for up to 1 month after the biopsy. If you had a transrectal biopsy, you may experience a small amount of bleeding from your rectum for 2 to 3 days after the biopsy.

If you have a transurethral biopsy, you may have a urinary catheter in place for a few hours after the biopsy. You also may need to take an antibiotic medicine for several days after the biopsy.

If you have a general anesthetic, you will be in a recovery room for a few hours after the biopsy. You will need someone to drive you home when you are released. When you get home, your muscles may ache and you may feel tired for the rest of the day.

Risks

A prostate biopsy has a slight risk of causing problems such as:

Infection. This is more common in men who have undiagnosedprostatitis. Usually, taking antibiotic medicine before the biopsy prevents an infection from developing.
Bleeding into the urethra or bladder. This can cause a blood blister(hematoma), an inability to urinate, or a need to urinate often.
Bleeding from the rectum. If you have a transrectal biopsy, you may experience a small amount of bleeding from your rectum for 2 to 3 days after the biopsy.
An allergic reaction to the anesthetic medicines used during the biopsy.

After the biopsy

Call your doctor immediately if you:

Have heavy bleeding or bleeding continues longer than 2 to 3 days.
Have increased pain.
Have a fever.
Are unable to urinate within 8 hours or have blood in the urine for longer than 2 to 3 days.

Results

A prostate gland biopsy is a test to remove small samples of prostate tissue to be examined under a microscope. Results are usually available within 10 days.

If cancer cells are present, a grade (Gleason score) will be given, which your doctor will discuss with you. The Gleason score is considered a tool for predicting how aggressive the cancer is.