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Prostate Biopsy


Your surgeon has ordered an ultrasound guided biopsy of the prostate. Below are frequently asked questions regarding this procedure. Please read all instructions upon receipt. Your prep for the procedure starts the week before the biopsy(holding blood thinning medications). Please notify nurse or physician if you are on any blood thinning medications; have a history of a bleeding disorder; and if you are allergic to the antibiotic prescribed.


The prostate is located between the urinary bladder and the rectum. This is why the rectal transducer is the best route to look at the prostate. The prostate is about the size a walnut, but may enlarge with age or certain conditions. The urethra, the tube that empties urine from the bladder, runs through the prostate like the core of an apple. The prostate is a many layered gland with the primary function of producing the liquid (semen) part of the ejaculate.


The back of the prostate can be examined in two ways. First, the physician can actually feel the rear surface of the prostate during a digital rectal exam (DRE) because the prostate is located in front of the rectum. Second, some abnormalities of the prostate can cause an elevation in a blood test called the prostatic specific antigen (PSA). An abnormality of either of these tests may indicate prostate cancer, benign (non-cancerous) tumors, infection, or enlargement of the prostate associated with increasing age.

Based on these findings, an ultrasound with biopsy is needed to further identify the cause of the abnormal DRE or elevated PSA.


Ultrasound examinations emit a high frequency sound wave that allow the physician and US technician to visualize the prostate for shape, size and abnormalities. No radiation is involved. The ultrasound image is obtained via a transducer/probe placed within the rectum.

A biopsy is a very small sampling of tissue obtained through the rectal transducer. The 12-core biopsies are performed under ultrasound visualization of the prostate. The biopsy tissue is sent to pathology for examination under a mircroscope. The report is usually available with 2-3 working days. This report guides the surgeon with what further treatment or follow-up is needed.


Image of patient undergoing procedureCutaway view of prostate

This procedure is performed in the Evergreen Imaging Department on the 2nd floor at TUCC. Allow about 30 minutes for this visit, although the procedure only takes about 10-15 minutes to complete. You will undress from the waist down and lay on your left side on an exam table. The lubricated transducer/probe will be inserted into the rectum. To reduce discomfort of the biopsies, you will receive a local anesthetic block to the nerves of the prostate. This is administered through the rectal transducer/probe. You remain awake during the procedure and are not premedicated other than with the antibiotics. If premedication is required prior to the biopsy, this must be arranged in advance with the surgeon and you must come with a driver - this is not typically needed.


What can I Expect after the Biopsy?

  • Rectal bleeding - a little bit of blood with a bowel movement is not unusual and may occur intermittantly for 2-3 weeks. However, if you see blood clots or there is persistant bleeding, please call us. This usually occurs immediately after the biopsy, if at all. It is okay to have a bowel movement after the biopsy, it should not be painful.

  • Blood in the urine is common - pink tinged is not unusual. Drink plenty of fluids to flush this minor bleeding. This may persist intermittantly for several weeks. If your urine is dark red with clots, especially along with difficulty urinating you must call the office.

  • Blood in the ejaculate may occur for up to 2-3 months after the biopsy. The ejaculate may be red streaked or brown tinged. This will not harm your partner. The blood will decrease with ejaculations.The biopsy should not affect your sexual ability or enjoyment. You may have discomfort with ejaculation for a limited period of time after the biopsy.

YOU MUST CALL TUCC at 303-825-8822 IF:

Fever of >101 degrees

Flu-like symptoms

Severe Pain

Difficulty urinating

Persistant bleeding/clots









1. ALL blood thinning medications must be stopped ONE TO TWO WEEKS prior to the procedure. Please review the list of Blood Thinning Agents(this includes aspirin,herbals and supplements) in this document. If you are on prescribed blood thinners, you must contact the prescribing physician as you may need to be on an alternate medication.

2. Take antibiotic prescription as prescribed.

3. Eat normally the day of the procedure - DO NOT FAST.

4. Use a Fleets enema (4 oz water enema) at home about 1-2 hours before the procedure.



Your appointment for the procedure is scheduled on:




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