Prostate Biopsy

1. What is a prostate biopsy?

A prostate biopsy is a procedure in which small samples of tissue are taken from the prostate gland to check for the presence of prostate cancer or other abnormalities. It is typically recommended when a PSA (prostate-specific antigen) blood test is elevated or if there are suspicious findings on a digital rectal exam (DRE) or MRI.

2. Why might I need a prostate biopsy?

Your urologist may recommend a biopsy if you have:

  • Elevated or rising PSA levels

  • Abnormal digital rectal exam

  • Suspicious areas on a prostate MRI

  • A family history of prostate cancer

A biopsy is the only definitive way to diagnose prostate cancer.

3. How is a prostate biopsy performed?

There are two common techniques:

  • Transrectal ultrasound-guided (TRUS) biopsy: A small probe is inserted into the rectum, and 12–14 samples are taken using a thin needle guided by ultrasound.

  • Transperineal biopsy: A newer method where samples are taken through the skin between the scrotum and anus, often under light sedation.

Some biopsies may also be MRI-targeted for greater precision.

4. Is a prostate biopsy painful?

Most patients tolerate the biopsy well. Local anesthesia is used to numb the area, and discomfort is usually minimal. Some pressure or brief cramping may be felt during the procedure.

5. What should I expect after the biopsy?

It’s normal to experience:

  • Mild discomfort or soreness for a day or two

  • Blood in the urine, stool, or semen (can last several days to a few weeks)

  • Mild urinary frequency or urgency

You can usually resume normal activity the next day, but strenuous exercise should be avoided for 24–48 hours.

6. Are there any risks or complications?

While generally safe, potential risks include:

  • Urinary tract infection (UTI)

  • Blood in urine, stool, or semen

  • Temporary difficulty urinating

  • Rare but serious infection (sepsis)

To reduce infection risk, your doctor will prescribe antibiotics before and after the procedure.

7. When will I get my biopsy results?

Biopsy results are typically available within 7–10 days. Your urologist will review the pathology report with you and explain:

  • Whether cancer was found

  • The Gleason score (a grading system for prostate cancer)

  • Next steps for treatment or monitoring

8. What happens if cancer is found?

If prostate cancer is detected, your urologist will discuss:

  • The stage and grade of the cancer

  • Whether the cancer is low-risk or aggressive

  • Treatment options, which may include:

    • Active surveillance

    • Radiation therapy

    • Surgery (prostatectomy)

    • Hormonal therapy, depending on the case

9. Can I avoid a biopsy with imaging or blood tests?

While MRI imaging and newer biomarkers (like ExoDx or 4Kscore) can improve risk assessment, a biopsy remains the only way to confirm if prostate cancer is present. Your urologist will use all available tools to help make a personalized recommendation.