About Your Prostate Biopsy With Ultrasound Under Anesthesia

This information will help you get ready for your prostate biopsy with ultrasound under anesthesia (medication to make you sleep during a procedure). It will also help you know what to expect after your biopsy.

About your prostate

Your prostate is a small, firm gland about the size of a walnut. It works with other glands in your body to make semen.

Your prostate is in front of your rectum, below your bladder (see Figure 1). It surrounds your urethra, the tube that drains urine (pee) from your bladder.

About your prostate biopsy

A prostate biopsy is a procedure to collect small pieces of tissue from your prostate. An ultrasound is an imaging scan that uses sound waves to make pictures of the inside of your body. Your healthcare provider will use ultrasound imaging during your biopsy. It will help them take tissue from the right areas of your prostate.

After your biopsy, the pieces of tissue will be looked at under a microscope to check for abnormal cells.

Getting ready for your prostate biopsy

Talk with your healthcare provider

Tell your healthcare provider if you:

• Take anticoagulants (blood thinners). These are medications that affect the way your blood clots.
• Take steroids, such as prednisone (Deltasone®).
• Take any other medications, including vitamin E, multivitamins, herbal remedies, or any other dietary supplements or home remedies.
• Have taken any antibiotics in the past 3 months.

Buy your supplies

Buy these supplies before your biopsy.

• 1 saline enema (such as a Fleet® saline enema). You can buy this at your local pharmacy without a prescription.
• Oral antibiotic (antibiotic that you swallow), if your healthcare provider tells you to. If you’re taking an oral antibiotic, your healthcare provider will give you a prescription. Read the “Oral antibiotics” section for more information.

Arrange for someone to take you home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.

7 days before your prostate biopsy

Stop taking certain medications

You may need to stop taking some of your medications before your biopsy. Examples include anticoagulants, aspirin, medications that contain aspirin, multivitamins, and vitamin E. Talk with your healthcare provider about which medications are safe for you to stop taking. Follow their instructions.

For information about medications that contain aspirin and vitamin E, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

2 days before your prostate biopsy

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil^® and Motrin^®) and naproxen (Aleve^®), can cause bleeding. Stop taking them 2 days before your procedure. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

The day before your prostate biopsy

A staff member from the Admitting Office will call you after 2 p.m. the day before your biopsy. If your biopsy is scheduled for a Monday, they’ll call you the Friday before. If you don’t get a call by 7 p.m., call 212-639-5014.

The staff member will tell you what time to get to the hospital for your biopsy. They’ll also remind you where to go. This will be one of these locations:

• Presurgical Center (PSC) on the 2nd floor
  1275 York Ave. (between East 67th and East 68th streets)
  M Elevator to 2nd Floor
• Presurgical Center (PSC) on the 6th floor
  1275 York Ave. (between East 67th and East 68th streets)
  B elevator to 6th Floor
• Josie Robertson procedure Center (JRSC)
  1133 York Ave. (between East 61st and East 62nd streets)

If you have any changes in your health or you need to cancel your biopsy for any reason, call your surgeon. Offices are usually open Monday through Friday from 9 a.m. to 5 p.m. After 5 p.m., during the weekend, and on holidays, call 212-639-2000. Ask for the doctor who is covering for your doctor.

Instructions for eating before your procedure

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Do not eat anything after midnight (12 a.m.) the night before your procedure. This includes hard candy and gum.



 

The day of your prostate biopsy

Instructions for drinking before your procedure

‌  You can drink a total of 12 ounces of water between midnight (12 a.m.) and 2 hours before your scheduled arrival time. Do not drink anything else.

Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Give yourself a saline enema

Give yourself a saline enema the morning of your biopsy. Follow the directions on the box.

Take your antibiotics

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

Oral antibiotics

Intravenous (IV) antibiotics

Your healthcare provider might decide you need IV antibiotics instead of oral antibiotics. If they do, you’ll get the IV medication through a vein in your arm while you’re in the hospital.

Things to remember

• Do not wear any metal objects. Take off all jewelry, including body piercings. The equipment used during your biopsy can cause burns if it touches metal.
• Do not put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
• Leave valuable items (such as credit cards, jewelry, and your checkbook) at home.
• If you wear contact lenses, wear your glasses instead. Wearing contact lenses during a procedure can damage your eyes. Remember to bring a case for them.

Get ready for your biopsy

• When it’s time to change for your procedure, you’ll get a hospital gown, robe, and nonskid socks to wear.
• The exact starting time of your biopsy may depend on the length of the procedure scheduled before yours. Your nurse will speak with you if there are any unexpected delays.
• Before you’re taken into the operating room, you’ll need to take off your hearing aids, dentures, prosthetic device(s), wig, and religious articles.

Your biopsy will take about 20 to 30 minutes.

After your prostate biopsy

After your biopsy, you will need to urinate before you leave the hospital.

It’s normal to have some soreness or discomfort after your biopsy, but most people don’t have pain. If you feel sore, you can take acetaminophen (Tylenol^®). If the acetaminophen doesn’t help, call your doctor’s office.

For 3 days after your biopsy, try to drink double the amount of liquids you usually drink. This will help flush out your bladder, prevent infection, and minimize the amount of blood in your urine. It will also help soften your bowel movements (poop), which helps keep your rectum from getting irritated.

Temporary effects on your bowel movements, urine, and semen

• You might see blood in your bowel movements. You might also have a small amount of bleeding from your rectum. These can happen right after your biopsy or for the next few days when you have a bowel movement.
• You might see blood in your urine for 1 to 2 weeks after your biopsy. This bleeding might come and go.
• Your semen might look rust-colored for up to 12 weeks after your biopsy. This is because small amounts of blood might be in it.

Activity

• Tell your nurse if you’ll be more than 2 hours away from MSK during the first 24 hours after your biopsy. If you have any problems after your biopsy, such as fever or bleeding, you might have to go to MSK’s Urgent Care Center (UCC).
• Don’t have sex for 3 days after your biopsy.
• For the next 5 days after your biopsy, do not:
  • Play any sports.
  • Work out in a gym.
  • Ride a bicycle.
  • Lift anything heavier than 10 pounds (4.5 kilograms).

Test results

Your test results will be ready 5 to 7 days after your biopsy. Your healthcare provider will contact you and explain the results to you. You can also ask for a copy of your results.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these things.

• A fever of 101 °F (38.3 °C) or higher.
• Heavy bleeding from your rectum.
• Bleeding from your rectum that will not stop.
• You can’t urinate.
• Bright red blood or large clots in your urine.
• Shaking chills.
• Dizziness.
• Any other problems, questions, or concerns.