A prostate biopsy is the removal of a small amount of tissue from the prostate gland. The tissue is examined to determine whether there is
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A prostate biopsy is usually done after an abnormal finding by: Digital rectal exam
Prostate specific antigen (PSA) blood test
A prostate biopsy is the only way to find out if cancer cells are present.
Problems from the procedure may occur, but all procedures have some risk. Your doctor will review potential problems, like: InfectionBruising or lengthy bleeding from the rectum, or in urine or semenDifficulty urinatingReactions to anesthesia
Factors that may increase the risk of complications include: SmokingHistory of bleeding disorders or easy bruisingUse of any medications, over-the-counter medications, or herbal supplementsSensitivity or allergy to latex, medications, or anesthesia
You may be asked to do the following:
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.
The type of anesthesia depends on the method that your doctor uses:
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.
Your doctor will use one of the following methods to do the biopsy: 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.
You may have discomfort and soreness at the biopsy site. Pain and discomfort after the procedure can be managed with medications.
When you return home after the procedure, do the following to help ensure a smooth recovery: 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.
After the sample is taken, it will be sent to a pathologist for examination under a microscope. This doctor will analyze the sample for cancer. If cancer is present, your doctor will work with you to develop a treatment plan.
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor: Inability to urinateBlood in the urine more than 2-3 days post-biopsySigns of infection, including fever and chillsPain that you cannot control with the medications you have been givenPain, burning, urgency, or frequency of urinationCough, shortness of breath, or chest painRectal bleeding that lasts more than 2-3 days after the biopsy
If you think you have an emergency, call for medical help right away.
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http://www.urologyhealth.org/urologic-conditions/prostate-cancer/causes. Updated April 2014. Accessed September 25, 2014.
How is prostate cancer diagnosed? American Cancer Society website. Available at:
http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-diagnosis. Updated September 12, 2014. Accessed September 15, 2014.
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Understanding prostate changes: A health guide for men. National Cancer Institute, National Institutes of Health website. Available at:
http://www.cancer.gov/types/prostate/understanding-prostate-changes. Accessed September 25, 2014.
7/13/2016 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T905693/Prostate-biopsy: Gershman B, Van Houten HK, et al. Impact of prostate-specific antigen (PSA) screening trials and revised PSA screening guidelines on rates of prostate biopsy and postbiopsy complications. Eur Urol. 2016 Mar 16.
Last reviewed September 2016 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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