Why You Might Need a Prostate Biopsy
If you’ve had an elevated PSA blood test, an abnormal prostate MRI, or an abnormal prostate exam, your urologist may recommend a prostate biopsy to check for prostate cancer. A biopsy allows us to examine small tissue samples from your prostate under a microscope to look for cancer cells.
There are two main types of prostate biopsy offered:
Standard vs. Fusion Prostate Biopsy
Standard (Systematic) Biopsy
-
Uses ultrasound guidance alone to map and sample the prostate.
-
Typically involves 12 cores taken from strategic zones throughout the gland.
-
Common first-line approach – typically if you have a very high PSA or a substantially abnormal examination
Fusion Biopsy
-
Combines MRI imaging with ultrasound to better target suspicious areas.
-
MRI lesions are overlaid with real-time ultrasound for more precise sampling.
-
Often used if you’ve had a recent MRI showing a PI-RADS 3–5 lesion or a prior negative biopsy but persistently elevated PSA.
- Improved accuracy and detection in most cases
What to Expect During the Procedure
-
Where: Most biopsies are performed in our office.
-
Anesthesia: Local numbing is used to block nerves to the prostate. You may also choose to receive nitrous oxide (laughing gas) for additional comfort (available for a fee).
-
Positioning: You’ll lie on your side in a fetal position.
-
A small ultrasound probe is gently inserted into the rectum to guide the biopsy.
-
Once the prostate is numbed, we take 12–15 needle samples from different regions of the prostate.
-
Each sample takes just a second, and the whole procedure takes about 8–12 minutes.
Most patients feel pressure during the sampling—not sharp, stabbing pain.
How to Prepare
1. Antibiotics:
You’ll start a 3-day course of antibiotics, beginning the day before the procedure.
2. Enema:
Do a rectal enema about 2 hours before your appointment to help clear the area and reduce infection risk.
3. Blood Thinners:
Tell us ahead of time if you’re taking any blood-thinning medications. You may need to pause them before the biopsy.
After the Biopsy
Some side effects are common and expected:
-
Blood in urine or stool for 2–3 days, often resolves on its own
-
Blood in semen for up to 3 months
(This is harmless but can be surprising if you’re not expecting it)
Most men return to work or normal activities the next day.
Risks of Prostate Biopsy
While the procedure is generally safe, a few risks include:
-
Infection (1–3%) – rarely, this can lead to a serious infection needing hospitalization and IV antibiotics.
-
Urinary retention – uncommon, but possible if swelling blocks urine flow.
-
Discomfort or mild rectal irritation – usually temporary.
When Will I Get Results?
Biopsy results are typically available in 7–10 days. Your results will fall into one of three categories:
-
Benign (no cancer found)
-
Low-grade or slow-growing prostate cancer (often monitored with active surveillance)
-
Clinically significant prostate cancer that may require treatment
We’ll go over everything together and help you decide on the best next steps based on your unique situation.
Have Questions?
Our team is here to help guide you through the process, from preparation to results. Call us at 207-518-6600 or request an appointment online.
Other Related Resources:
Active surveillance for Prostate Cancer
Robotic Prostate Cancer Surgery
Radiation Therapy
