Is a Needle Biopsy of the Prostate?
needle biopsy of the prostate is a procedure in which your
doctor removes tiny pieces of tissue from your prostate
gland. The bits of tissue are then studied under a microscope
to see if there are any abnormalities.
Your prostate is a gland located just below your bladder.
It wraps around the upper part of your urethra (the tube
that carries urine from your bladder through your penis
to the outside of your body). The prostate makes a fluid
that nourishes and protects sperm.
Do I Need a Needle Biopsy of the Prostate?
needle biopsy is done when your doctor has good reason to
suspect that you may have prostate cancer. Your doctor will
probably recommend that you have a needle biopsy if:
digital rectal exam has revealed abnormalities in the
size, shape, or texture of your prostate, and/or
prostate-specific antigen (PSA) level is abnormally
elevated. PSA is a protein made by prostate cells. The
PSA blood test is an important screening test for the
early detection of prostate cancer.
abnormalities may be the result of the normal aging process,
or they may indicate that there is a problem with your prostate,
such as an infection, a noncancerous (benign) tumor, or
Do I Prepare for the Procedure?
doctor might prescribe an antibiotic for you to start taking
before the biopsy and continue to take for a day or so afterwards.
This will reduce your risk for infection.
Tell your doctor if you regularly take aspirin or any other
drug that thins the blood. You may be instructed to stop
using the aspirin or drug several days before the biopsy.
This may help keep you from bleeding too much when the tissue
samples are removed from your prostate.
Your rectum needs to be free of stools so your doctor can
safely insert the instruments needed to perform the needle
biopsy. A clean rectum will further reduce your risk for
infection. In order to cleanse your lower bowel and rectum,
you will have to give yourself an enema before you arrive
at your doctor's office for the biopsy.
Is a Needle Biopsy of the Prostate Done?
urologist can safely perform a prostate biopsy in his or
Immediately before the biopsy, you may be given a sedative
to help you relax. Your doctor may also inject a numbing
medication into your prostate to keep you from feeling pain
when the tissue samples are removed.
During the procedure, you will lie on an examination table
on your left side with your knees drawn toward your chest.
Your doctor will insert into your rectum an ultrasound probe
that has been draped with a condomlike latex cover and lubricated
with a special gel. The probe contains an ultrasound transducer,
a device that releases and detects high-frequency sound
waves. Attached to the side of the ultrasound probe is a
small tube called a needle guide.
When the probe is inside your rectum, you will feel pressure
similar to the feeling you have before a bowel movement.
You won't feel the sound waves come out of the transducer,
but you may feel the movement of the probe as your doctor
adjusts its location. The sound waves will bounce off your
prostate and other nearby structures, and the reflected
sound waves—or echoes—will be detected by the
transducer. A computer will convert the echoes into black-and-white
images (called sonograms) that your doctor can view on a
TV monitor. Your doctor will use the sonograms to pinpoint
the exact location of your prostate, measure its size, and
identify areas that look abnormal.
When your doctor is ready to remove a piece of tissue from
your prostate, he or she will activate the needle guide
to release a hollow, spring-loaded needle. Every time the
doctor releases the needle, it will quickly enter and exit
your prostate, removing a tiny sliver of tissue. Your doctor
will remove 8 to 12 or more samples of tissue from your
prostate in this way. You will hear a clicking or popping
sound each time your doctor activates the needle guide.
You will probably feel some discomfort each time the needle
enters your prostate, but because the needle moves so quickly,
the discomfort should be brief.
After your doctor has obtained all the necessary tissue
samples, the ultrasound probe will be removed from your
What Happens After the Procedure?
You will be able to leave your doctor's office shortly after
the procedure is over. You should avoid strenuous activities
for the rest of the day. You may notice some blood in your
urine, semen, or stools for a day or two (sometimes longer)
after the procedure.
Although it is possible that you could develop a prostate
infection following a prostate biopsy, the antibiotic medications
prescribed by your doctor should help prevent this.
Call your doctor if you develop a fever, experience severe
pain or bleeding, pass blood clots, or have any other unexpected
symptoms within a few days after the procedure.
Your prostate tissue samples will be sent to laboratory,
where they will be examined by a specially trained doctor
called a pathologist. Once your diagnosis has been determined,
the pathologist will report his or her findings to your
The pathologist will use the samples from the different
areas of your prostate to create a map of the gland. If
cancer or other abnormal cells are present, the map will
show the location of those cells. This information will
be useful to your doctor as he or she considers your treatment
If cancer is found in your prostate, the pathologist's report
will provide information about the cancer's grade. The grade
may give an indication of how aggressively the cancer will
grow and spread.