Preparing for a Prostate Biopsy
A prostate biopsy is the removal of small tissue samples from the prostate with fine needles when a raised PSA, an examination finding or a suspicious area on MRI is found. The biopsy can be taken through the skin between the anus and the scrotum (transperineal) or through the back passage (transrectal). This guide summarises preparation, the symptoms to expect afterwards and when to seek help immediately.
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This guide is general information; the instructions you receive personally always take priority.
During a prostate biopsy, small tissue samples are taken from the prostate with fine needles under ultrasound guidance and sent for pathological examination. If there is a suspicious area on MRI, targeted samples are taken from it (MRI-fusion biopsy), usually together with systematic samples. You will be told in advance which route (transperineal or transrectal) and which type of anaesthesia is planned for you.
Before the procedure
- Most patients have a multiparametric prostate MRI before the decision to biopsy. Please bring the CD with your MRI images and the report.
- Do not stop or change your blood thinners without talking to your doctor. Tell us about all your medicines in advance, including herbal products; if your medicine needs adjusting, you will be told exactly how.
- If you have been prescribed a preventive antibiotic, take it exactly at the time and for the length of time you have been told.
- If a transrectal biopsy is planned, you may be asked to clear your bowel; follow the instructions you are given.
- If sedation or general anaesthesia is planned, do not eat or drink for the period you have been told. For a biopsy under local anaesthetic you usually do not need to fast; if you are unsure, ask.
- Tell us in advance about: burning when passing urine or a fever, recent antibiotic use or hospital stays, diabetes, and any drug allergies (particularly to antibiotics or local anaesthetics).
- If you are having sedation or anaesthesia, arrange for someone to accompany you home.
What to bring:
- Your identity document
- Your MRI CD and report, PSA and other test results
- An up-to-date list of your medicines
On the day
The biopsy is performed under local anaesthetic, or with sedation or general anaesthesia. An ultrasound probe is placed in the back passage to view the prostate. As each sample is taken, you may feel brief pressure and hear a “click” from the biopsy device. The procedure is short. After a brief period of observation, most patients go home the same day.
After the procedure: the first days
The following are common and usually settle on their own:
- Pink urine or slight bleeding, which may last a few days
- After a transrectal biopsy, a small amount of blood in your stools or on the toilet paper
- Blood or a brown colour in your semen; this can last several weeks and is not harmful to you or your partner
- After a transperineal biopsy, mild pain or bruising in the area between the anus and the scrotum
- Mild discomfort when sitting
A fever or shivering after a biopsy can be a sign of infection and must be assessed without delay.
Care at home
- Fluids: Drink plenty of water spread through the day for the first few days.
- Antibiotics: If you have been prescribed them, finish the course even if you feel well.
- Activity: Rest on the day of the biopsy. For a few days, avoid heavy lifting, strenuous exercise, cycling and horse riding.
- Showering: You can usually shower the same day or the next day.
- Driving: If you have had sedation or anaesthesia, do not drive for at least 24 hours.
- Work: Most people can return to work the next day; if your work is physically demanding, talk to your doctor.
- Sex: You can resume when you feel comfortable. Blood in the semen on its own is not a cause for concern.
- Constipation: Eat a high-fibre diet to avoid straining.
- Blood thinners: Ask your doctor when to restart them.
Follow-up
- You will be told on the day of the biopsy when your result is expected. Pathological examination takes a certain amount of time.
- Your results and the next steps are discussed in person at your follow-up appointment. Book this appointment before you leave.
- Whatever the result, your follow-up plan is tailored to you by considering your PSA, MRI and pathology findings together.
For more information, see the prostate cancer page.
Contact
- Appointments and follow-up visits: Özel Medicabil Nilüfer Hastanesi, 444 8 112 (weekdays 08:30–12:00); Özel Jimer Hastanesi, 444 45 67 (weekdays 13:00–17:00).
- Emergencies: Call 112 or go to your nearest emergency department. Do not use messaging apps (such as WhatsApp) for emergencies.