prostate gland biopsy is a test to remove small
samples of prostate tissue 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 the anus and
scrotum (perineum). A transrectal biopsy is the most common
method used. The tissue samples taken during the biopsy are examined for
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.
the biopsy is done through the rectum, you may need to have an
enema before the biopsy.
If the biopsy is
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
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.
positions are possible for this method. You may be asked to kneel, lie on your
side, or lie on your back with your feet resting in stirrups. Your doctor may
inject a local anesthetic around the prostate gland before the biopsy is
Transrectal ultrasound (TRUS) is generally used to
guide the needle to the correct biopsy location. A prostate biopsy is usually
done with a spring-loaded needle. The needle quickly enters the prostate gland
and removes a tissue sample. Between 6 and 12 samples are taken from different
areas of the prostate.
The biopsy can also be done with a needle
guide attached to your doctor's finger. He or she inserts the finger into the
rectum. Then the needle is slid along the guide, through the wall of the
rectum, and into the prostate gland. The needle is turned to collect a tissue
sample and then pulled out.
this method, you will lie on your back with your feet resting in stirrups.
local anesthesia may be used.
scope (cystoscope) is inserted into your urethra. It allows
your doctor to look directly at the prostate gland. A cutting loop is passed
through the cystoscope to remove small pieces of prostate tissue.
A transurethral biopsy usually takes about 30 to 45 minutes.
Through the perineum (transperineal biopsy)
Transperineal biopsy is not done as commonly as transrectal or
transurethral biopsy. You will lie on an examining table either on your side or
on your back with your knees bent. General or local anesthesia may be
skin at the biopsy site is cleaned with an antiseptic solution, and the area
around it is covered with sterile cloth. Your doctor will wear sterile gloves.
It is very important that you do not touch this sterile area.
Transrectal ultrasound (TRUS) is generally used to
guide the needle to the correct biopsy location.
A small cut (incision) is made in your perineum. Your doctor
inserts a finger into the rectum to hold the prostate gland and then inserts
the needle through the incision and into the prostate gland. To collect a
sample of tissue, the needle is gently turned and then pulled out. Biopsy
samples may be taken from several areas of the prostate. Pressure is applied to
stop the bleeding, and a small bandage is placed over the cut. The biopsy
usually takes about 15 to 30 minutes.
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.
A prostate biopsy has a slight risk of causing
problems such as:
Infection. This is more common in men who have
prostatitis. Usually, taking antibiotic medicine
before the biopsy prevents an infection from developing.
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.
types of prostate cancer are treated. There are many things to consider when
deciding on a treatment plan. To learn more, see the topic
A prostate gland biopsy
does not cause problems with erections and will not make a man
Other Works Consulted
Loeb S, Carter HB (2012). Early detection, diagnosis, and staging of prostate cancer. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2763–2770. Philadelphia: Saunders.
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis:
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
Zelefsky MJ, et al. (2011). Cancer of the prostate. In VT DeVita Jr et al., eds., DeVita, Hellman and Rosenberg's Cancer: Principles and Practice of Oncology, 9th ed., pp. 1220–1271. Philadelphia: Lippincott Williams and Wilkins.
ByHealthwise Staff Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine Specialist Medical ReviewerChristopher G. Wood, MD, FACS - Urology, Oncology
How this information was developed to help you make better health decisions.