Prostate model

We Answer Your Questions About Prostate Biopsies

Let’s face it: Prostate biopsy is a topic that can make men anxious. If you’ve been told you should have one, chances are you have a lot of questions. In this article, we’ll answer some of the most common questions men have about the prostate biopsy.

1. What Is a Prostate Biopsy?

A prostate biopsy is a procedure where small samples of potentially cancerous tissue are extracted and analyzed. It’s generally performed by inserting a needle transrectally (through the rectal wall) or transperineally (through the skin between the scrotum and anus) and extracting the tissue. The transrectal biopsy is more common.

2. Why Would My Doctor Recommend a Prostate Biopsy?

Doctors will generally recommend a biopsy if you meet one or more of the following criteria:

  • You have an elevated prostate-specific antigen (PSA) level after multiple tests.
  • Your doctor finds lumps or hardness during a digital rectal exam.
  • You still have elevated an PSA level despite a normal biopsy.
  • A previous biopsy found non-cancerous yet abnormal cells.

As more evidence emerges about the lack of precision in PSA tests in detecting cancer, doctors are less likely to recommend a biopsy solely based on those tests and more likely to suggest a digital rectal exam (DRE).

3. What Should I Do Before the Biopsy?

You’ll need to provide a urine sample to confirm you don’t have a urinary tract infection, stop taking any medication or supplements that increase the risk of bleeding, and your doctor may ask you to perform a cleansing enema. You may also be prescribed antibiotics before the procedure.

4. What Happens During a Prostate Biopsy?


You’ll be asked to lie on your side, drawing your leg or legs up to your chest to make the rectum or perineum more accessible. Then, your prostate will be scanned using an ultrasound device, and you’ll receive local anesthetic.

Once the prostate is mapped out, the doctor will take ten to twelve samples from areas of potential concern, using a spring-loaded needle. You’ll experience some slight discomfort when the needle is deployed, and the procedure will last about twenty minutes.

For more detail about what to expect from a prostate biopsy, see this blog post.

5. What Should I Do After the Biopsy?

You’ll be asked not to exert yourself too much for one to two days after the procedure. You may feel a little sore in the area as well.

Monitor your semen, urine, and feces. A small amount of blood or a rust tinge may be present due to a small amount of bleeding from the sampled area.

If you have a fever, trouble urinating, increasing pain, or heavy bleeding, call a doctor immediately.

6. What Happens Next?

The prostate cells are examined under a microscope for indications of any malignancy or abnormality. If cancerous cells are found, they’ll  be graded with a Gleason score. The score uses two numbers on a scale of 1 to 5, with 1 being normal cells and 5 being highly cancerous. The two scores are then added together. A score of 2 means no cancer; a 10 means highly dangerous cancer.

The Gleason score will drive any treatment decisions your doctor makes, although there are other factors involved, including age, other medical conditions you may have, and the side effects of treatment. Prostate cancer is relatively common in older men and rarely causes mortality, so your doctor may decide to monitor the tumor instead of treating it.

For More Information

If you’d like to learn more about your prostate and the role it plays in men’s health, please see our User’s Guide to the Prostate.

For more about prostate cancer, follow the eDrugstore blog.

If you’re already struggling with erectile dysfunction, with or without prostate surgery, see our ED medication guide or call 1-800-467-5146 to take advantage of our free medical consultation to find the erectile dysfunction medication that’s right for you. Virtual health visits and shipping are always free.

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