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Prostate Needle Biopsy

Prostate needle biopsy is a test to help rule out prostate cancer. During the test, a thin needle is used to take small samples of tissue from the prostate. The samples are then tested in a lab. This sheet explains the procedure and what to expect.

Side view cross section of male anatomy showing the prostate, rectum, bladder, penis, testis, urethra and symphsis.

Preparing for the Procedure

Prepare as you have been told. In addition:

Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as Coumadin, Plavix, or daily aspirin. You may need to stop taking some or all of them before surgery.
You may be told to use a laxative, enemas, or both before the biopsy. This is to empty the colon and rectum of stool. Follow the instructions you are given.
Your doctor may prescribe antibiotics before the procedure. If so, take these as directed.

The Day of the Procedure

The procedure is done in a doctor’s office or a hospital. It takes about 15 minutes. You will be able to go home the same day. Transrectal ultrasound is often used during the procedure. This test uses sound waves to make images that help the doctor insert the needle in the correct place. During the biopsy:

If ultrasound will be used, you may be asked to drink water to fill your bladder.
You may lie on your side on an exam table. Or, you may lie on your back with your legs in the air.
The ultrasound transducer is lubricated. It is then inserted into the rectum. This will feel like a prostate exam. The transducer is moved until the prostate can be seen in the ultrasound images.
To numb the biopsy area, local anesthesia may be injected.
Using the ultrasound images as a guide, the biopsy needle is inserted. It may be inserted through the rectum, or through the perineum (the skin between the scrotum and the anus).
The needle is used to take tissue samples from the prostate. These samples are sent to a lab to be tested for cancer.

After the Biopsy

At first you may feel a little faint. You can lie on the table until you feel able to stand. Once you are okay to leave, you can go back to your normal routine. Be aware that having some blood in the urine and stool is normal after this procedure. You may also notice blood in your ejaculate (semen) for weeks or months after the biopsy. This is expected and not dangerous. Your doctor can tell you more about what to expect.

Call the Doctor If You Have Any of the Following:

Chest pain or trouble breathing (call 911 or other emergency service)
A fever of 100.4°F or higher
Weakness or shaking chills
Blood clots in the urine
Bloody diarrhea
Inability to urinate for 6 hours
Blood in the urine or stool that doesn’t go away in 48 hours

Follow-Up

You will see your doctor for a follow-up visit. Depending on the biopsy results, you may be scheduled for more tests. If signs of cancer are found, you and your doctor can discuss options for further testing.