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 1). It surrounds your urethra, which drains urine from your bladder. The gland also adds fluid to your semen.

Male reproductive system

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 _____________________ (healthcare provider).

Before Your Procedure

Tell your healthcare provider 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.

5 to 7 days before your procedure

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

You can read about medications that contain aspirin and vitamin E in the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

2 days before your procedure

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

You can read about NSAIDs in the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

We recommend that you have a responsible adult take you home after your procedure. 

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The Day of Your Procedure

  • 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.
  • We recommend that you have a responsible adult take you home after your procedure.


You will need to take an antibiotic to prevent infection from the biopsy. Your healthcare provider will tell you which antibiotic you will take and give you a prescription. You will take one of the antibiotics listed below. 

Oral antibiotics

  • Ciprofloxacin 500 mg (2 tablets)
    • Take the first tablet 2 hours before your procedure.
    • Take the second tablet 12 hours later.
  • Cefixime (Suprax) 400 mg (1 tablet)
    • Take 1 tablet 2 hours before your procedure.
  • Cefuroxime (Ceftin) 500 mg (2 tablets)
    • ​Take the first tablet 2 hours before your procedure.
    • Take the second tablet 12 hours later.

Intravenous antibiotics

Your healthcare provider may decide that you need intravenous (IV) antibiotics instead of oral antibiotics. In that case, you will get the IV medication through a vein in your arm 1 hour before your procedure.  

  • Ceftriaxone
  • ​Meropenem
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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 healthcare provider to see your entire prostate. The biopsies are done through the ultrasound probe.

Prostate biopsy

The biopsy can cause temporary pain, so your healthcare provider will 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 healthcare provider may take up to 16 biopsy samples. You can expect to be in the biopsy room for 20 to 30 minutes.

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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.
    • Increase how much liquids you drink for 3 days after your procedure. Try to drink double the amount of liquids that you usually drink. This will help to flush out your bladder, prevent infection, and minimize the amount of blood in your urine.
  • Your semen may appear “rusty” for up to 12 weeks after the biopsy. This is because small amounts of blood may be in it. 


  • 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).
  • 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.
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Test Results

  • Your test results will be ready in 5 to 7 days after your biopsy. Your healthcare provider will explain the results to you. You can also ask for a copy of your results.
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Call Your Healthcare Provider 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
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