Prostate Biopsy and Ultrasound: About This Test

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Transrectal prostate biopsy with detail showing where needle is placed

What is it?

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

This test is done by a doctor who specializes in men's genital and urinary problems (urologist). It can be done in your doctor's office, a day surgery clinic, or a hospital operating room. To get the tissue samples from the prostate, the doctor inserts a thin needle through the rectum, the urethra, or the area between the anus and scrotum (perineum). The most common method is through the rectum. Your doctor may use ultrasound to help guide the needle.

Why is this test done?

You may need a prostate biopsy if your doctor found something of concern during a digital rectal examination. Or you may need it if a blood test showed a high level of prostate-specific antigen (PSA). A biopsy can help find out if you have prostate cancer.

How can you prepare for this test?

Before you have a prostate biopsy, tell your doctor if:

  • You are taking any medicines or using any natural health products.
  • You are allergic to any medicines.
  • You have had bleeding problems, or you take aspirin or some other blood thinner.

What happens before the test?

  • You may need to have an enema before the test.
  • You will need to take off all or most of your clothes. You will be given a cloth or paper gown to use during the test.
  • You may be given a sedative through a vein (IV) in your arm. The sedative will help you relax and stay still.

What happens during the test?

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 the prostate to numb the area before the sample is taken.
  • Ultrasound is often used to guide the needle to the correct spot.
  • Your doctor may choose to use a needle guide for the biopsy. He or she will attach the guide to a finger. Your doctor will insert the finger into your rectum.
  • The needle will enter the prostate and take 6 to 12 samples.

Through the urethra

  • You will lie on your back. Your feet will rest in stirrups.
  • You will get anesthesia. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • Your doctor will insert a lighted scope (cystoscope) into your urethra. The scope allows your doctor to look directly at the prostate. Your doctor will pass a cutting loop through the scope to remove samples of prostate tissue.

Through the perineum

  • You will lie on an examination 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 he or she will insert a finger into the rectum to hold the prostate.
  • Your doctor will then insert the needle through the cut and into the prostate.
  • The needle collects samples of tissue and is then pulled out.

What else should you know about this test?

  • A prostate biopsy has a slight risk of causing problems such as infection or bleeding.
  • If the biopsy went through your rectum, you may have a small amount of bleeding from your rectum for 2 to 3 days after the biopsy.
  • You may have a little pain in your pelvic area. You may also have a little blood in your urine for 1 to 5 days.
  • You may have some blood in your semen for a week or longer.

How long will the test take?

  • This test will take about 15 to 45 minutes.

What happens after the test?

Your doctor will tell you what to expect and watch for after your test. In general:

  • If you have anesthesia that makes you sleep, you will be in a recovery room for a few hours. You will need someone to drive you home. You may feel tired for the rest of the day.
  • You will probably be able to go home right away.
  • If your doctor had you stop taking any medicine for the biopsy, ask him or her when you can start taking it again. If you were given antibiotics, take them as directed.
  • Do not do heavy work or exercise for 4 hours after the test.
  • Your doctor will tell you how long it may take to get your results back.

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 call line 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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