Prostate Biopsy for Men
If your PSA is elevated or your MRI showed something worth a closer look, a prostate biopsy gives you and your urologist a definitive answer, most often in about 20 minutes, with results in 7 to 10 days.
Why Patients Are Referred
- Elevated Prostate-Specific Antigen (PSA)
- Abnormal or suspicious MRI finding
- Active surveillance of previously diagnosed prostate cancer
- Abnormal digital rectal exam (DRE)
What is a Prostate Biopsy?
A prostate biopsy is a procedure in which a urologist removes several small samples of tissue from the prostate gland so they can be examined under a microscope for cancer or other abnormalities. It’s the only way to confirm a prostate cancer diagnosis. Imaging and blood tests like PSA can raise suspicion, but a biopsy provides the definitive tissue answer.
At Virginia Urology, biopsies are performed using ultrasound or MRI-fusion imaging for guidance, in an ambulatory surgery center or hospital setting, with sedation options tailored to your comfort level.
Reasons Your Doctor May Recommend a Biopsy
Elevated PSA
A rising or elevated Prostate-Specific Antigen level on a blood test is the most frequent reason a biopsy is ordered, since PSA alone can't distinguish cancer from benign prostate conditions.
Abnormal MRI Scan
A multiparametric MRI that identifies a suspicious lesion (often scored using the PI-RADS system) is frequently used to target the biospy needle precisely.
Active Surveillance
Men already diagnosed with low-risk prostate cancer who are being monitored rather than treated typically undergo periodic biopsies to track any change in the diease.
Biopsy Techniques
Types of Prostate Biopsy We Perform
Transrectal Ultrasound-Guided (TRUS) Biopsy
The most established approach: an ultrasound probe is placed in the rectum to visualize the prostate while a thin needle collects tissue samples from multiple areas of the gland.
MRI-Fusion Guided Biopsy
Prior MRI images are digitally “fused” with real-time ultrasound, allowing your urologist to target specific suspicious areas identified on imaging in addition to standard systematic sampling, often improving detection accuracy.
Your urologist will recommend the approach best suited to your anatomy, prior biopsy history, and imaging findings.
The Day of Your Biopsy
What Happens During the Procedure
- Imaging Guidance
- Using ultrasound (with or without MRI fusion), your urologist visualizes the prostate in real time.
- Tissue Sampling
- A thin, spring-loaded needle quickly collects small core samples from different regions of the prostate. The procedure typically takes 10 to 20 minutes.
- Lab Analysis
- Samples are sent to pathology, where they’re examined for cancerous or abnormal cells.
How to Get Ready for Your Biopsy
Preparation typically begins a couple of days before your procedure and continues through the day after, to reduce your risk of infection and help with recovery.
- Pick up your prescribed antibiotics (commonly Ciprofloxacin and Cefdinir) as soon as your biopsy is scheduled, and take them exactly as directed before and after the procedure.
- Take Tamsulosin (Flomax) as prescribed to support urine flow and help prevent urinary retention after the biopsy.
- Purchase an over-the-counter Fleet Enema to use at home shortly before you leave for your appointment, if instructed.
- Talk with your doctor or cardiologist about pausing blood thinners or aspirin – never stop a prescribed medication without medical guidance.
- Arrange a ride home if you’re receiving nitrous oxide or general anesthesia.
Note: Your consulting urologist and the physician who performs your biopsy may be different providers within our practice.
After your Biopsy
What to Expect Afterward
It’s common to notice small amounts of blood in your urine, stool, or semen for several days to a few weeks; this typically resolves on its own. Continue your prescribed antibiotics and Tamsulosin through the day after your procedure and avoid strenuous activity for 24 to 48 hours.
Contact our office promptly if you experience fever, chills, heavy bleeding, or inability to urinate.
Getting Your Results
A follow-up appointment will be scheduled 7 to 10 days after your biopsy, giving the lab time to complete the pathology analysis. On that visit, your urologist will walk you through your results and, if needed, discuss next steps and treatment options together.
Frequently Asked Questions
Most men feel pressure rather than sharp pain. The procedure is performed with local anesthesia, nitrous oxide, or general anesthesia, and discomfort is generally mild and short-lived.
The biopsy itself usually takes 10 to 20 minutes. With check-in, prep, and a short recovery period, plan for about 1.5 hours to 3 hours depending on type of anesthetic used.
A follow-up appointment is typically scheduled 7 to 10 days after your biopsy so your urologist can review the completed pathology report with you.
The most common effects are minor blood in the urine, stool, or semen and mild soreness. Less common risks include infection or temporary urinary retention, which is why preventive antibiotics and Tamsulosin are typically prescribed.
Often yes, but the exact timing depends on your specific medication and health history. Always consult your prescribing doctor or cardiologist before stopping any medication.
A transrectal biopsy passes the needle through the rectal wall; a transperineal biopsy passes it through the skin between the scrotum and rectum. Your urologist will recommend the best fit for you.
Want to learn more?
Contact us today to learn more about getting a prostate biopsy. Click the button below to schedule an appointment.
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