What is Prostate Biopsy?
A prostate biopsy is a procedure to remove samples of suspicious tissue from the prostate. The prostate is a small, walnut-shaped gland in men that produces fluid that nourishes and transports sperm.
During a prostate biopsy a needle is used to collect a number of tissue samples from your prostate gland. The procedure is performed by a doctor who specializes in the urinary system and men’s sex organs (urologist).
Why is Prostate Biopsy performed?
The purpose of prostate biopsy is to diagnose prostate cancer. Your urologist may recommend a prostate biopsy if results from initial tests, such as a prostate-specific antigen (PSA) blood test or digital rectal exam, suggest you may have prostate cancer. Tissue samples from the prostate biopsy are examined under a microscope for cell abnormalities that are a sign of prostate cancer. If cancer is present, it is evaluated to determine how quickly it’s likely to progress and to determine your best treatment options.
What should I know before receiving Prostate Biopsy?
Initially, patients with a prostate-specific antigen (PSA) value higher than 4.0 ng/mL were believed to have an absolute indication. Biopsy typically was also recommended for patients with suspicious findings on digital rectal examination (DRE). However, the current established practice is that no PSA value exists that can establish with absolute certainty whether a patient does or does not have prostate cancer. Thus, the decision whether to proceed with prostate biopsy must be individualized in every case.
Prostate biopsy is contraindicated in cases such as the surgical absence of a rectum or the presence of a rectal fistula.
In most cases, a doctor will administer an anesthetic injection into the prostate gland before the procedure. Despite the numbness from the anesthetic, a man may still feel a pinch as the needle punctures the gland.
Most men report that they only feel mild to moderate discomfort during the procedure, but some men experience much greater pain.
Afterward, as with any invasive procedure, there may be lingering tenderness and discomfort as the puncture wounds heal.
Risks associated with a prostate biopsy include:
- Bleeding at the biopsy site. Rectal bleeding is common after a prostate biopsy.
- Blood in your semen. It’s common to notice red or rust coloring in your semen after a prostate biopsy. This indicates blood, and it’s not a cause for concern. Blood in your semen may persist for a few weeks after the biopsy.
- Blood in your urine. This bleeding is usually minor.
- Difficulty urinating. In some men, prostate biopsy can cause difficulty urinating after the procedure. Rarely, a temporary urinary catheter must be inserted.
- Rarely, men who have a prostate biopsy develop an infection of the urinary tract or prostate that requires treatment with antibiotics.
How to prepare for Prostate Biopsy?
To prepare for your prostate biopsy, your urologist may have you:
- Provide a urine sample to analyze for a urinary tract infection. If you have a urinary tract infection, your prostate biopsy will likely be postponed while you take antibiotics to clear the infection.
- Stop taking medication that can increase the risk of bleeding — such as warfarin (Coumadin), aspirin, ibuprofen (Advil, Motrin IB, others), and certain herbal supplements — for several days before the procedure.
- Do a cleansing enema at home before your biopsy appointment.
- Take antibiotics 30 to 60 minutes before your prostate biopsy to help prevent infection from the procedure.
What happens during Prostate Biopsy?
The entire procedure usually takes about 10 minutes.
During the procedure, the doctor inserts an ultrasound probe into the rectum to create an image of the prostate gland. The prostate is located just on the other side of the rectal wall.
Using the ultrasound image as a guide, the doctor removes several samples from the prostate with a spring-loaded tool.
The device quickly punches a needle through the rectal wall into the prostate and removes minute cylindrical cores of cells. Typically, a biopsy removes around 10 to 12 core samples, usually five or six from each side of the prostate.
In some cases, a doctor may decide that a larger sample is needed. In these cases, the doctor performs a “saturation” biopsy, which collects 20 to 30 samples, sometimes more.
After the biopsy, doctors may suggest that men take an antibiotic to prevent infection.
Another procedure called a transperineal biopsy involves making a small cut between the anus and the scrotum. The biopsy needle is inserted through the cut and into the prostate and extracts a sample of tissue. The doctor will likely use an ultrasound scan to guide the procedure.
What happens after Prostate Biopsy?
After the biopsy, further tests and examinations carried out in the lab will help the doctor determine how fast any cancer is growing, how likely it is to spread, and the best course of treatment to pursue.
If you have any questions about the Prostate Biopsy, please consult with your doctor to better understand your instructions.
Explanation of results
What do my results mean?
One of the most common ways to grade the type of cancer that may be present is by applying the Gleason score, which classifies cancer into one of five distinct categories.
To classify the biopsy, a doctor examines the tissue under a microscope and determines which two areas in the sample have the highest concentration of cancer cells. They then assign each of these samples a value of 1 – 5.
Adding the two values together gives the Gleason score. The lower the score, the less advanced the cancer is likely to be.
Depending on the laboratory and hospital, the normal range for Prostate Biopsy may vary. Please discuss with your doctor any questions you may have about your test results.
Hello Health Group does not provide medical advice, diagnosis or treatment.
What Is a Prostate Biopsy? https://www.webmd.com/men/what-is-prostate-biopsy#1. Accessed June 25, 2018.
Prostate biopsy. https://www.mayoclinic.org/tests-procedures/prostate-biopsy/about/pac-20384734. Accessed June 25, 2018.
Prostate biopsy: What to expect. https://www.medicalnewstoday.com/articles/317601.php. Accessed June 25, 2018.
Prostate Biopsy. https://emedicine.medscape.com/article/1949728-overview#a5. Accessed June 25, 2018.
Review Date: October 9, 2018 | Last Modified: September 12, 2019