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Prostate Needle Biopsy

Side view cross section of male pelvis showing the prostate and rectum.

Prostate needle biopsy is a test used to check for prostate cancer. You may hear it called a core needle biopsy. During the test, a thin, hollow needle is used to take small pieces of tissue (called samples) out of the prostate. The samples are then tested in a lab to see if there are cancer cells in them. This test is the main way to diagnose prostate cancer.

Getting ready for the procedure

Prepare as you have been told. Here are some things you can expect:

  • Tell your healthcare provider about all medicines you take. This includes herbs, vitamins, and other supplements. Be sure to mention any blood thinners, including daily aspirin. You may need to stop taking some or all of them before the biopsy.

  • Ask if you can eat the day of your biopsy.

  • You may be told to use a laxative, enemas, or both before the biopsy. This is to clean stool out of your colon and rectum. Follow the instructions you are given.

  • Your healthcare provider may have you take antibiotics before the biopsy. If so, take these as directed.

Risks and possible complications 

Your provider will talk with you about possible risks before the biopsy is done. Risks are rare, but include:

  • Trouble passing urine

  • Infection in your urinary tract or prostate

  • Blood infection

  • Bleeding inside your body

The day of the procedure

Prostate biopsy can be done in a healthcare provider’s office or a hospital. It takes about 45 minutes. You'll be able to go home the same day. But you'll need someone to drive you home.

Transrectal ultrasound is often used during the procedure. This test uses sound waves to make images of your prostate on a computer screen. The images help the healthcare provider put the needle in the right place. In some cases, an MRI scan is used to "see" the prostate instead of or along with ultrasound.

During the biopsy:

  • If ultrasound will be used, you may be asked to drink water to fill your bladder.  

  • You will put on a hospital gown and lie on an exam table. 

  • The ultrasound transducer, which is about the size of a finger, is lubricated. It's then put into your rectum. This will feel like a prostate exam and you'll feel pressure. The transducer is moved until the prostate can be seen on the screen.  

  • Medicines called local anesthetics may be used to numb the biopsy area. You might also be given medicine to make you sleepy.

  • Using the ultrasound images as a guide, the biopsy tool (biopsy gun) is put against the prostate.

    • It may be put in through the rectum, then the needle goes through the wall of your rectum and into your prostate. This is called a transrectal ultrasound (TRUS) guided biopsy.

    • Or, the biopsy gun can be put against the skin between your scrotum and anus (perineum). The needle then goes through your skin into your prostate. This is the transperineal approach.

  • The needle is used to take tissue samples from the prostate. It moves in and out of your prostate very quickly. But you might feel stinging or burning. About 12 samples are taken from different parts of the prostate. These samples are sent to a lab to be tested.

After the biopsy

At first you may feel a little lightheaded, especially if you had medicine to make you sleepy. You can stay on the table until you feel able to stand. You can go home once you're feeling better.

You can go back to your normal activities right away. But you might find it uncomfortable to sit for 1 to 2 days. You may see some blood in your stool for a few days. This is normal. You may also notice blood in your urine and semen for a few weeks after the biopsy. This is also normal. Be sure to finish your antibiotics as directed. Your healthcare provider can tell you more about what to expect.

Follow-up care

You will see your healthcare provider for a follow-up visit. Depending on the biopsy results, you may be need more tests. If cancer is found, you and your healthcare provider can discuss what the next steps will be.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

  • Blood clots in your urine

  • Bloody diarrhea

  • Blood in your urine or stool that doesn’t go away after 48 hours

  • Chest pain or trouble breathing (call 911)

  • Chills

  • Feeling weak

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Cannot pass urine

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Richard LoCicero MD
Date Last Reviewed: 12/1/2019
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