A prostate biopsy is a common medical procedure used to diagnose prostate cancer. This process involves collecting small tissue samples from the prostate gland for examination under a microscope. It is a fundamental step in evaluating prostate health, particularly when initial tests suggest potential concerns.
Before Your Biopsy
Preparing for a prostate biopsy involves important steps for safety and effectiveness. Your healthcare provider will discuss your medical history, including any medications you are currently taking. Inform them about blood-thinning medications (e.g., warfarin, aspirin, ibuprofen, herbal supplements), as you may need to stop these several days before to reduce bleeding risk.
Antibiotics are prescribed to prevent infection, starting a day or two before and continuing for a short period afterward. You may also be asked to perform a cleansing enema at home before your appointment to clear the rectum. While there are no strict dietary restrictions, light meals may be suggested the day before. Arrange for transportation home, especially if sedation is used.
Understanding the Procedure
The prostate biopsy is performed using different approaches, with the most common being the transrectal ultrasound (TRUS) guided biopsy. During this procedure, you will lie on your side with your knees bent towards your chest. A doctor will insert a finger-sized ultrasound probe into the rectum, which allows for real-time imaging of the prostate gland. This probe helps guide the biopsy needle precisely.
Once the prostate is visualized, a local anesthetic is injected around the gland to numb the area, minimizing discomfort during the tissue collection. A thin, spring-loaded needle is then quickly inserted through the rectal wall into the prostate, taking small, cylindrical tissue samples. You may hear a clicking sound and feel a brief pressure or flicking sensation each time a sample is taken. About 10 to 12 tissue samples are collected from various areas of the prostate. The entire TRUS-guided procedure takes around 10 to 20 minutes.
An alternative method is the transperineal biopsy, where samples are taken through the skin between the scrotum and the anus, an area known as the perineum. This approach involves general anesthesia or spinal anesthesia, though local anesthetic can also be used. An ultrasound probe is still inserted into the rectum to guide the needle, but the biopsy needle passes through the skin of the perineum into the prostate. This method is preferred when targeting suspicious areas identified by an MRI or to reduce the risk of infection. The transperineal biopsy can take between 20 to 45 minutes, depending on the number of samples collected.
After the Biopsy
Following a prostate biopsy, patients can expect a recovery period lasting a few days to a couple of weeks. It is common to experience some side effects, such as mild soreness or discomfort in the biopsy area. You may also notice blood in your urine, stool, or semen. Blood in the urine resolves within a few days, while blood in the stool can last up to five days. Blood in semen can persist for several weeks.
Your doctor will advise light activities for 24 to 48 hours after the procedure and recommend avoiding strenuous exercise, heavy lifting, and sexual activity for several days to a week. Continue taking any prescribed antibiotics as directed to prevent infection. It is important to contact your healthcare provider if you develop a fever, experience heavy bleeding, have difficulty urinating, or notice increasing pain, as these could be signs of complications. The tissue samples are sent to a specialized doctor for examination, and your healthcare provider will discuss the results with you once they are available, typically within three to seven business days.