Prostate Biopsy

What is a Prostate Biopsy?

Prostate biopsy is an office procedure during which we take small samples of tissue from the prostate gland to determine whether or not a man might have prostate cancer.

Who Needs a Prostate Biopsy?

If there is a concern that a man might have prostate cancer, a prostate biopsy is usually recommended.  The 2 most common reasons for recommending a prostate biopsy are an elevated PSA or an abnormality found on a prostate exam by your family doctor or your urologist.  In addition, men with prostate cancer treated with active surveillance rather than surgery or radiation will require periodic prostate biopsies to make sure things are not getting worse.  Finally, if there is suspicion of cancer recurrence after treatment, another biopsy might be necessary.

How is a Prostate Biopsy Done?

Prostate biopsy is a simple, 20 or 30 minute procedure done in your urologist’s office under local anesthesia.  We use ultrasound for guidance to ensure that the biopsies are taken from the proper locations.  Antibiotics are given to reduce the small risk of infection and you will need to use an enema a few hours before to clean out the rectum.  If you are taking blood thinners such as aspirin or Coumadin, you will need to stop these medications several days prior to the biopsy.  In most cases you can drive yourself to and from the office for the biopsy.

During the biopsy, you will lie on your left side on an exam table with your knees pulled up towards your chest.  Your urologist will usually do another digital rectal exam and put some numbing medicine in the rectum.  A small ultrasound probe is then placed in the rectum and your urologist will take detailed pictures and measurements of your prostate.  A small needle is then inserted through the ultrasound probe and numbing medicine is injected around the prostate.  Using a different, specialized needle that is also inserted through the ultrasound probe, your urologist will take 4 to 6 biopsies from each side of your prostate.  The biopsy specimens are placed in preservative fluid and sent to the laboratory for a pathologist to look at them under the microscope.  The ultrasound probe is then removed and the procedure is done.

The risks of prostate biopsy include bleeding and infection.  If antibiotics are given, the risk of infection is about 2–3%.  If you are not taking blood thinners or if they are stopped prior to the biopsy, the risk of bleeding is about 1.5%.  Signs that something is wrong after a biopsy include fever, worsening pain and trouble urinating.

What Should I Expect After a Prostate Biopsy?

You may resume normal activities immediately after the biopsy although it is a good idea not to do any heavy lifting for 24 hours.  Most men have some rectal discomfort for a day or 2.  You will likely see blood in the urine off and on for as much as a week or 2.  A little rectal bleeding for a day or so is not uncommon.  In addition, most men notice blood in their semen for a few weeks after a biopsy.  Biopsy results are usually available within a few days.

We hope that this answers some of your questions about prostate biopsy.  Call Gallatin Urology (406-551-2306) for an appointment if you need more information or if you have concerns about prostate cancer.