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(Transrectal Biopsy; Transurethral Biopsy; Transperineal Biopsy)
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Reasons for Procedure
- Digital rectal exam
- Prostate specific antigen (PSA) blood test
- Bruising or lengthy bleeding from the rectum, or in urine or semen
- Difficulty urinating
- Reactions to anesthesia
- History of bleeding disorders or easy bruising
- Use of any medications, over-the-counter medications, or herbal supplements
- Sensitivity or allergy to latex, medications, or anesthesia
What to Expect
Prior to Procedure
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Begin taking an antibiotic.
- Use an enema several hours before the procedure.
- If you will be getting general anesthesia, do not eat or drink anything after midnight.
Transurethral biopsy and perineal biopsy:
- General anesthesia—Blocks pain and keeps you asleep through the surgery. This will be used for a transrectal prostate biopsy.
- Local anesthesia—Just the area that is being operated on is numbed, given as an injection and may also be given with a sedative.
Description of the Procedure
- Transrectal biopsy (most common method)—Your doctor will insert a small ultrasound device into the rectum. This device will produce sound waves to create an image of the prostate. These images will help guide placement of the needle. Your doctor will then insert the needle through the wall of the rectum and into the prostate gland.
- Transurethral biopsy—Your doctor will insert a lighted flexible tube through the penis into the urethra. The urethra carries urine from the bladder. Your doctor will get the biopsy with a cutting loop that is passed through the flexible tube.
- Perineal biopsy—Your doctor will make a small incision in the perineum. The perineum is the area between the scrotum and the rectum. The doctor will insert a small needle into the prostate gland to get the biopsy.
How Long Will It Take?
Will It Hurt?
- Stay hydrated. Drink plenty of fluids for the next few days.
- Avoid difficult physical activity the day and evening of the procedure.
- Keep in mind that you may see blood in your urine, stool, or semen for several days.
- Resume any medications that were stopped when you are advised to do so.
Call Your Doctor
- Inability to urinate
- Blood in the urine more than 2-3 days post-biopsy
- Signs of infection, including fever and chills
- Pain that you cannot control with the medications you have been given
- Pain, burning, urgency, or frequency of urination
- Cough, shortness of breath, or chest pain
- Rectal bleeding that lasts more than 2-3 days after the biopsy
- Reviewer: Mohei Abouzied, MD, FACP
- Review Date: 09/2016
- Update Date: 07/13/2016