Are you awake during a prostate biopsy?

If you have a biopsy using a local anaesthetic, you are awake during the procedure and the anaesthetic numbs the prostate and the area around it. The doctor will put an ultrasound probe into your back passage, using a gel to make this easier.

prostatecanceruk.org - Prostate biopsy

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What are the side effects of a biopsy?

Having a biopsy can cause side effects. These will affect each man differently, and you may not get all of the possible side effects.

Pain or discomfort

Some men feel pain or discomfort in their back passage (rectum) for a few days after a TRUS biopsy. Others feel a dull ache along the underside of their penis or lower abdomen (stomach area). If you have a transperineal biopsy, you may get some bruising and discomfort in the area where the needle went in for a few days afterwards. If you receive anal sex, wait about two weeks, or until any pain or discomfort from your biopsy has settled, before having sex again. Ask your doctor or nurse at the hospital for further advice. Some men find the biopsy painful, but others have only slight discomfort. Your nurse or doctor may suggest taking mild pain-relieving drugs, such as paracetamol, to help with any pain. If you have any pain or discomfort that doesn’t go away, talk to your nurse or doctor.

Short-term bleeding

It’s normal to see a small amount of blood in your urine or bowel movements for about two weeks. You may also notice blood in your semen for a couple of months – it might look red or dark brown. This is normal and should get better by itself. If it takes longer to clear up, or gets worse, you should see a doctor straight away. A small number of men who have a TRUS biopsy may have more serious bleeding in their urine or from their back passage (rectum). This can also happen if you have a transperineal biopsy but it isn't very common. If you have severe bleeding or are passing lots of blood clots, this is not normal. Contact your doctor or nurse at the hospital straight away, or go to the accident and emergency (A&E) department at the hospital.

Infection

Some men get an infection after their biopsy. This is more likely after a TRUS biopsy than after a transperineal biopsy. It's very important to take any antibiotics you’re given, as prescribed, to help prevent this. But you might still get an infection even if you take antibiotics.

Symptoms of a urine infection may include:

pain or a burning feeling when you urinate

dark or cloudy urine with a strong smell

needing to urinate more urgently than usual

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needing to urinate more often than usual during the day or night

a high or very low temperature

pain in your lower abdomen (stomach area) or back.

If you have any of these symptoms, contact your doctor or nurse at the hospital straight away. If you can’t get in touch with them, call your GP. Less than 1 in 100 men (one per cent) who have a TRUS biopsy get a more serious infection that requires going to hospital. If the infection spreads into your blood, it can be very serious. This is called sepsis. Symptoms of sepsis may include:

a high temperature (fever)

chills and shivering

blue, pale or blotchy skin, lips or tongue

a fast heartbeat

fast breathing or difficulty breathing

confusion or changes in behaviour.

If you have symptoms of sepsis, go to your nearest hospital A&E department straight away.

Acute urine retention

A small number of men find they suddenly and painfully can’t urinate after a biopsy – this is called acute urine retention. This happens because the biopsy can cause the prostate to swell, making it difficult to urinate. Acute urine retention may be more likely if you have a template biopsy. This is because more samples are taken, so there may be more swelling. Your doctor will make sure you can urinate before you go home after your biopsy. If you can’t urinate, you might need to have a catheter for a few days at home – this is a thin tube that’s passed into your bladder to drain urine out of the body. If you develop acute urine retention at home, contact your doctor or nurse at the hospital straight away, or go to your nearest A&E department. You might need a catheter for a few days.

Sexual problems

You can masturbate and have sex after a biopsy. If you have blood in your semen, you might want to use a condom until the bleeding stops. A small number of men have problems getting or keeping an erection (erectile dysfunction) after having a biopsy. This may happen if the nerves that control erections are damaged during the biopsy. It isn’t very common and it should get better over time, usually within two months. Speak to your doctor or nurse if you’re worried about this.

prostatecanceruk.org - Prostate biopsy

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