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 the test takes

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

With general anesthesia, you won't feel anything during this procedure. With local anesthesia, you may have some discomfort while numbing medicines are being injected and feel pressure in the rectum while the ultrasound probe is in place. And with local anesthesia, you may still feel some pressure or discomfort as the biopsy needle removes samples from the prostate. Usually about 10 to 12 samples are collected.

A prostate biopsy rarely causes problems with erections. It doesn't affect your fertility.

A prostate biopsy has a risk of causing problems such as:

• Infection. A urinary tract infection is the most common infection that can happen after a prostate biopsy. Less common infections include prostatitis, bacteremia, and sepsis. You will likely be given an antibiotic before the test to lower your chance for getting an infection.
• Urinary blockage. You may be unable to urinate after the biopsy if the swelling in your prostate blocks the flow. Or, in rare cases, the urine flow may be blocked by a blood clot caused by bleeding into the urinary tract.

Results are usually ready within several days.

Normal prostate biopsy results do not rule out cancer. There's a chance that a cancer may be missed since the biopsy takes a small amount of tissue.

If the test finds prostate cancer cells, your biopsy report will include a Gleason score and a Grade Group number. These numbers are ways of describing how the cancer cells look under a microscope and how likely those cells are to grow quickly and spread. Your doctor will discuss this with you.