The Prostate Biopsy Procedure: What Happens?

The prostate is a small, glandular organ approximately the size of a ping-pong ball nestled in the groin. It gives the body seminal fluid, which functions to not only help sperm travel but also survive when the two are mixed together in the journey to fertilize the egg. It also carries antibodies that protect the urinary tract and sperm from harmful pathogens and bacteria. The prostate itself has six major surfaces: two lateral ones, a posterior, an anterior, an apex, and a base.

At one point in their lifetimes, about 1 in 9 men in the United States will be diagnosed with prostate cancer. The disease, unfortunately, is often asymptomatic, though a prostatic tumor could press upon the urethra and cause symptoms such as:  

• Decreased urine flow
• Difficulty urinating
• Blood in the semen or urine
• Painful ejaculation or urination
• Erectile dysfunction
• Loss of bladder control
• Increased urges to urinate at night time
• Difficulty starting or stopping while urinating
• If your prostate cancer has metastasized to surrounding bones or tissues, you may develop other symptoms, including:
• Bone pain that may cause fractures
• Swelling in your pelvic area or legs
• Pain or numbness in your legs, feet, or hips

If your doctor suspects you could have prostate cancer, it’s likely they’ll suggest performing a prostate biopsy to take samples of tissue from your prostate. The current gold standard of prostate cancer screening involves first performing a PSA test, which measures the amount of prostate-specific antigen (PSA) in your blood. Unfortunately, they’re only about 21% accurate. If your PSA test comes back abnormal, your doctor will then generally recommend a biopsy. They’re performed one of two ways:

1. Transrectally, or through the rectal wall. This is the most common way to perform a prostate biopsy.
2. Transperineally, or through the area of skin located between the scrotum and anus.

To get ready for your biopsy, your doctor will likely:

• Have you stop taking medication that could increase the likelihood that you’ll bleed more.
• Test you for a urinary tract infection. If you have one, your procedure will probably be postponed so you can take a course of antibiotics to get rid of the infection.
• Prescribe you a prophylactic dose of antibiotics an hour to 30 minutes before your biopsy to help prevent infection.
• Have you do an at-home enema before the appointment.

During the procedure, you’ll be asked to lie on your stomach or on your side with your knees against your chest before your doctor will gently insert the probe into your rectum. They’ll retrieve samples using a spring-propelled needle, which will likely cause a bit of discomfort as it’s happening. Depending on whether or not your biopsy is assisted by an ultrasound, your doctor may or may not target a specific area of suspicion, or they may take samples from various, random places in the prostate. The procedure takes about 10 minutes total.

In the aftermath, your doctor may suggest you take it easy for a day or two. You may also need to be on an antibiotic for a few days to prevent infection, and you could experience soreness in your rectum, blood in your stool, urine, or semen.

That’s where Ezra comes in: our approach involves using MRI to screen for cancer in the prostate, which may help you avoid unnecessary, invasive biopsies which pose the risk of infection. If you’d like to learn more about our screening options, you can do so at this link.