What happens during a prostate biopsy

Hearing the words, “You need a prostate biopsy,” can be unsettling and scary.  But it doesn’t need to be. When men understand what a prostate biopsy is, why it’s necessary, and how it is performed, they will gain confidence and self-assurance about the procedure.    

A biopsy is any type of procedure that involves taking a piece of tissue from the body to be examined under a microscope.  A doctor will determine if the tissue contains cancer or abnormal cells.  Depending of the results of the biopsy can help determine the next best step in diagnosis or treatment.  

When it comes to a biopsy of the prostate, your urologist may recommend a biopsy if the result from a prostate specific antigen (PSA) blood test comes back abnormal or has risen to a level that might indicate prostate cancer or a digital rectal exam (DRE) feels suspicious.  Before performing a biopsy, your urologist will take into account your age, general health, family history, ethnic background as well as the results of other testing.  Performing a prostate biopsy will determine whether prostate cancer is present or not, and if so, which treatment option is best and appropriate for the type and stage of cancer diagnosed. 

The basics of a prostate biopsy

What exactly does a prostate biopsy entail?  The procedure itself usually only takes a quick 10 to 15 minutes and is often done in the urologist’s office.  Based upon your risk assessment determined by your urologist, your procedure may vary in the core number of tissue specimens obtained and may include MRI imaging. 

Before the biopsy begins, an antibiotic will be given to reduce the possibility of infection.  During the biopsy, medicine is used to numb the nerves that supply the prostate so you should only feel some pressure but no sharp pain while the procedure is taking place.  This is accomplished by the urologist placing a probe in the rectum and will then numb the area with an injection of a local anesthetic.  Then, the doctor will insert a thin, hollow needle through the wall of your rectum, into the prostate.  When the needle is pulled out, it removes a small amount of prostate tissue.  Multiple tissue samples from different areas of the prostate will be taken.

The samples are sent to a lab where they will be examined under a microscope for abnormal cells with the results coming back in a few days.  If the results are positive for cancer, the biopsy will help your doctor counsel you on your best treatment options.

After the procedure, you will be asked to take it easy for a day or two.  You may feel some tenderness in the area of the biopsy.  There may also be some blood in your urine or you may have some light bleeding from your rectum.  When you ejaculate, you may also notice blood in your semen for up to several weeks.  These symptoms are considered normal after a prostate biopsy, but if they persist or symptoms become worse, contact your urologist as soon as possible. 

Prostate biopsies are considered very safe procedures and are valuable for helping you and your doctor decide on what treatments may need to occur.  Always discuss with your doctor any questions or concerns you may have about your prostate biopsy.