(Transrectal Biopsy; Transurethral Biopsy; Transperineal Biopsy)
DefinitionA prostate biopsy is the removal of a small amount of tissue from the prostate gland. The tissue is examined to determine whether there is cancer.
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Reasons for ProcedureA prostate biopsy is usually done after an abnormal finding by:
- Digital rectal exam
- Prostate specific antigen (PSA) blood test
Possible ComplicationsProblems from the procedure are rare, 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
- 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 ProcedureYou 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.
AnesthesiaThe 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
- Local anesthesia—just the area that is being operated on is numbed, given as an injection and may also be given with a sedative
- Transrectal prostate biopsy—local anesthesia
Description of the ProcedureYour 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 your rectum and into the prostate gland.
- Transurethral biopsy—Your doctor will insert a lighted flexible tube through the penis 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.
Postoperative CareWhen you return home after the procedure, do the following to help ensure a smooth recovery:
- Stay hydrated. Drink plenty of fluids for the next few days.
- Avoid difficult physical activity the day and evening of the procedure.
- Keep in mind that you may see blood in your urine, stool, or semen for several days.
- Resume any medications that were stopped when you are advised to do so.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.