The Prostate Biopsy - What to Expect

Biopsy is an essential part of the definitive diagnosis of your prostate cancer. Sometimes this procedure can be a source of anxiety and concern.
So what should you expect when you are told you that you need to undergo a biopsy?

What to do in the days before the biopsy.

• Be sure to let your doctor know about any major medical conditions that you have. Most importantly, any type of heart or lung disease needs to be brought up.
• Give your doctor a full list of your medications. Pay special attention to make sure that all medications that thin the blood are listed. Coumadin (or warfarin), plavix (clopidogrel), aspirin, and heparin are a few of the common blood thinners that you need to alert your physician that you take. Your physician will likely have you stop taking these prior to the procedure to minimize the risk of bleeding.

What to expect the day of the procedure.

Your physician likely will instruct you to use an enema either at home or at the office a few hours before the procedure. While unpleasant, this is an important part of the preparation period before the biopsy. The enema will make the biopsy easier to perform and may lessen your chances of an infection afterward.

You should only drink clear liquids the morning of the procedure. Additionally, many physicians instruct their patients to drink a large amount of water in the hours before the procedure. Some doctors feel that an expanded bladder makes it easier to clearly see the prostate and surrounding structures on ultrasound.

In addition to your regular medications, most physicians will prescribe a short course of antibiotics to be started the night before or the morning of your biopsy.

What to expect during the procedure.

Your doctor will instruct you to lay on your side (usually your left side) with your knees pulled up.

Some local anesthetic (numbing medicine) will be injected into the skin around where the biopsy needles will be placed.

A thin ultrasound probe will be placed into your rectum in order to obtain an image of the prostate and surrounding structures. This will be left in place during the procedure.

The biopsy specimens are then taken by inserting very thin hollow needles into the prostate. Twelve samples from various areas of the prostate are taken to be sure that the whole prostate is checked for cancer.

You may have some pain and discomfort as the biopsies are being taken despite the use of the numbing medication. This is considered normal as long as the pain is minimal.

The whole procedure usually lasts roughly 20 minutes.

What to expect after the procedure.

• The biopsy samples will be sent to a laboratory where a pathologist will determine if cancer or another condition is present.
• Your physician will give you specific instructions about what you need to do after your procedure, but usually he/she will instruct you to resume eating normal foods, continue the course of antibiotics that was prescribed, drink extra water over the ensuing few days in an effort to further clean out your urinary system, and to continue NOT taking any blood thinners you were told to stop prior to the procedure (at least for a few days following the procedure).

What you could experience after the procedure.

• Some men have rectal soreness for a few days. This can be alleviated with warm soaks or compresses to the area.
• Some men experience light bleeding or spots of blood in their stool, urine, or semen. If the amount of bleeding is small and it stops after a few days, this is considered normal.