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About Your Prostate Biopsy With Ultrasound

This information will help you prepare for your prostate biopsy with ultrasound at Memorial Sloan Kettering (MSK).

Your prostate is a walnut-shaped gland that is located below your bladder and sits directly in front of your rectum (see figure). It surrounds your urethra, which drains urine from your bladder. The gland also adds fluid to your semen. 

A prostate biopsy is done to collect small pieces of tissue from the gland for examination under a microscope.

You have been scheduled for a prostate biopsy with ultrasound on ___________________ (date) with Dr. _____________________.

Your procedure will take place at the following MSK location:

Sidney Kimmel Center for Prostate and Urologic Cancers
353 East 68th Street (between First and Second Avenues)
Concourse Level
New York, NY 10065
 

Before Your Procedure

Tell your doctor if you:
  • Take medication to thin your blood (anticoagulants), such as:
    • Aspirin
    • Clopidogrel (Plavix®)
    • Dalteparin (Fragmin®)
    • Heparin
    • Warfarin (Coumadin®)
  • Take steroids such as prednisone
  • Take any other medications, such as herbs, vitamins, minerals, or natural or home remedies
  • Have taken any antibiotics in the past 3 months 
  • Have any sort of heart condition
  • Have implanted devices such as knee or hip replacements
  • Are allergic to any medications
  • Are allergic to latex
  • Had a urinary tract infection (UTI) in the last month
  • Had an infection or were hospitalized after a previous prostate biopsy
  • Have a history of Achilles tendon injuries or tendonitis
  • Have difficulty hearing
  • Work in a hospital or nursing home

10 days before your procedure

  • Stop taking:
    • Aspirin
    • Products that contain aspirin
    • Vitamin E

2 days before your procedure

  • Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • Ibuprofen (Advil® or Motrin®)
    • Naproxen (Aleve®)

The Day of Your Procedure

  • You can eat your regular breakfast the morning of your procedure.
  • Do a Fleet® enema the morning of your procedure. You can purchase it at your local pharmacy without a prescription. Follow the instructions on the box.
You will need to take an antibiotic to prevent infection from the biopsy. Your doctor or nurse will tell you which antibiotic you will take. Check the box next to the antibiotic that you will take below:
 
  • Ciprofloxacin 500 mg (2 tablets)
                - Your doctor will give you a prescription for this medication.
                - Take the first tablet 2 hours before your procedure.
                - Take the second tablet 12 hours later.
 
  • Gentamicin (injection)

               - Your nurse will give you the injection 1 hour before your procedure.

  • Ceftriaxone (injection)

                - Your nurse will give you the injection 1 hour before your procedure.

  • Imipenem (injection)

               - Your nurse will give you the injection 1 hour before your procedure.

Notes

During Your Procedure

Prostate ultrasound

For the ultrasound, a probe will be gently inserted into your rectum. An anesthetic lubricant will be put on it to help it slide in easily.

Sound waves will be emitted from the end of the probe. They bounce off your prostate and are detected by the probe. These sound waves are transformed into a picture that allows your doctor to see your entire prostate. The biopsies are done through the ultrasound probe.

Prostate biopsy

The biopsy can cause temporary pain, so your doctor may use a local anesthetic. This will numb the area around your prostate. You will also get an injection to numb the biopsy site. It will be similar to what you get at a dentist’s office.

A high-speed biopsy gun with a small, thin needle will be used to take each biopsy. Your doctor may take up to 16 biopsy samples. You can expect to be in the biopsy room for 20 to 30 minutes.

After Your Procedure

Temporary effects on your stool, urine, and semen

  • You may see blood in your stool. You may also have a small amount of bleeding coming from your rectum. These can occur right after your procedure or for the next few days when you move your bowels.
  • Blood may be in your urine for 7 to 14 days after your procedure. This bleeding may come and go. Drink at least 6 to 8 glasses of liquids for 5 to 7 days to minimize the amount of blood in your urine. Limit your intake of liquids after 8:00 pm to avoid trips to the bathroom during the night.
  • Your semen may appear “rusty” for up to 12 weeks after the biopsy. This is because small amounts of blood may be in it.

Activity

  • Do not engage in any sexual activity for 3 days after your procedure.
  • For the next 5 days after your procedure, do not do any sports, work out in a gym, ride a bicycle, or lift any objects heavier than 10 pounds.

Important Points

  • It is not required, but we recommend that you have a responsible adult take you home after your procedure.
  • You should plan to be in the local tristate area for the first 24 hours after your procedure. If you have any problems after your procedure, such as fever or bleeding, you may have to go to the MSK Urgent Care Center (UCC).

Test Results

  • Your test results will be ready in 5 to 7 days after your biopsy. Your doctor or nurse will explain the results to you. You can also ask for a copy of your results.

Call Your Doctor or Nurse if You Develop:

  • Bright red blood or large clots in your urine
  • Heavy or continued bleeding out of your rectum
  • An inability to urinate
  • A temperature of 101° F (38.3° C) or higher
  • Shaking chills
  • Dizziness

The information in this resource is selective and does not cover all possible side effects; others may occur. Please report any problems to your doctor or nurse.