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Prostate Biopsy: About This Test

Location of prostate between bladder and urethra in front of rectum, with detail of urethra passing through prostate.

What is it?

A prostate biopsy is a type of test. Your doctor takes about 10 to 12 small tissue samples from your prostate. Then another doctor looks at the tissue under a microscope to see if there are cancer cells.

Why is this test done?

You may need a prostate biopsy if your doctor found something of concern in your lab work or during your exam. A biopsy can help find out if you have prostate cancer. It may also be done for other reasons, such as monitoring the growth of prostate cancer for someone on active surveillance.

How do you prepare for the test?

Before you have a prostate biopsy, tell your doctor if you are taking any medicines or using any natural health products, or if you are allergic to any medicines. And tell your doctor if you have had bleeding problems, or you take aspirin or some other blood thinner.

How is the test done?

Some people have a prostate imaging test, such as an MRI or a CT scan, before their biopsy. The test results are used during the biopsy to select the areas of the prostate to sample.

Before your 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.

Through the rectum

  • You may be asked to kneel, lie on your side, or lie on your back.
  • Your doctor may inject an anesthetic around and into the prostate to numb the area before samples are taken.
  • An ultrasound probe will be gently inserted into your rectum.
  • A thin tool with a spring-loaded needle will be inserted next to the ultrasound probe. The ultrasound helps to locate the areas on the prostate where the samples will be taken. If you had an MRI or CT scan, the test results will also be used to guide the sampling.
  • The needle enters the prostate and removes a sample. About 10 to 12 samples are usually taken.

Through the perineum

  • You will lie on an exam table either on your side or on your back with your knees bent. You will get anesthesia. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • Your doctor will make a small cut in your perineum. Then the doctor will collect samples from the prostate through the cut with a special tool.
  • An ultrasound probe inserted into the rectum may be used to help find the locations in the prostate where samples need to be taken. Sometimes other imaging, such as MRI, is used instead of or along with ultrasound. Or the test results from other imaging, such as an MRI or a CT scan, may be used to guide the sampling.
  • If you have a general anesthetic, you will be in a recovery room for a few hours after the biopsy.

How long will the test take?

This test will take from 15 to 45 minutes, depending on how it's done.

What happens after the test?

You will probably be able to go home right away, and you may feel tired the rest of the day. Your muscles may ache. Don't do heavy work or exercise for 4 hours after the test.

You may have mild pain in your pelvic area and blood in your urine for up to 5 days. You may have some blood in your semen for a week or longer. You may also have a change in colour of your semen for up to 1 month after the biopsy.

If the prostate samples are taken through the rectal wall (transrectal biopsy), you may have a small amount of bleeding from your rectum for 2 to 3 days after the biopsy.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

Where can you learn more?

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