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Prostate Biopsy

Preparing for your biopsy:

  • Be sure you have stopped all "blood thinning medications" as instructed by your doctor.  These include aspirin, warfarin (Coumadin), and Plavix. These should have been stopped for 7 days prior to the biopsy date.
  • Your doctor prescribed antibiotics prior to your biopsy.  Make sure to take these as directed.
  • Several hours prior to your biopsy you will administer a rectal enema. The purpose of this is to cleanse the rectum, which decreases the chances of infection and provides better ultrasound guidance for the procedure.

What to expect at your biopsy visit:

  • The nurse will confirm you have stopped any blood thinning medications and that you took your antibiotics and enema as directed.
  • You will be asked to undress and put on an exam gown.
  • You will then lie on your left side on the exam table with your knees bent up toward your chest.
  • The doctor will gently insert the ultrasound probe and locate the prostate.
  • A local anesthetic (numbing medicine) will then be injected through the ultrasound probe to numb the prostate and rectum.
  • While the medicine is taking effect, the doctor will measure the dimensions of the prostate.  You will feel slight turning and movement of the ultrasound probe during this.
  • Once the prostate is numb, the doctor will take biopsies of the prostate. Usually 12 are performed.
  • The biopsy device makes a loud click when it takes a biopsy.
  • After the last biopsy, the doctor will remove the ultrasound probe.

See a picture of how a prostate biopsy is performed.

What to expect after your biopsy:

  • The antibiotics will dramatically lower the chances of infection from a prostate biopsy, but still, infection is possible.
    • Be sure to report any FEVER > 101 degrees Fahrenheit
  • About 50% of men will have some degree of blood in the urine after a biopsy. Be sure to drink plenty of fluids and flush out the bladder.
  • All men have blood in the stool after a prostate biopsy. This usually resolves within 48 hours.
  • All men have blood in the semen (ejaculate fluid) after a prostate biopsy. This can persist for up to 6 weeks after the biopsy and may appear maroon or brownish.  It is not painful or dangerous.

Post biopsy restrictions and instructions:

  • Avoid sexual activity for 48 hours
  • No heavy lifting for 24 hours
  • Try to avoid straining with bowel movements. You may use an over the counter stool softener if necessary
  • You may resume your blood thinning medication 2-3 days after the biopsy as long as there is no more blood in the stool or urine.

Call right away if any of the following occur:

  • FEVER > 101 degrees Fahrenheit
  • Heavy or persistent rectal bleeding
  • Heavy or persistent blood in the urine
  • Inability to urinate
  • You develop a rash due to your medicine or antibiotics

Results:

  • The pathologist needs to prepare and examine the biopsies accurately. This takes about 5-7 days.
  • You will receive a phone call with your biopsy results, unless you specifically requested not to be called.  If the results are positive (meaning cancer in the prostate) your doctor will inform you and give you a follow up appointment to come in and discuss treatment options.  At WakeMed Physician Practices - Urology, it is important to us that you are comfortable with the information provided and the time you have with your doctor. The prostate cancer discussion visits are always booked for extra time at the end of the day so that you, your family, and your doctor can discuss all the available treatments at length.  Extra time is built into the appointment to provide you all the time you need with your doctor to thoroughly review the disease and the available treatments, and to ask any questions you may have.