Preparing for prostate biopsy includes stopping medications that elevate the risk for bleeding, performing a cleansing enema at home ahead of the appointment and taking antibiotics an hour before the biopsy to stave off infection, according to Mayo Clinic. Warfarin, ibuprofen, aspirin and some herbal supplements make bleeding more likely.
Prostate biopsy generally takes place in one of three ways: going through the tip of the penis to get a tissue sample; sending a needle through the rectal wall; and sliding the needle through the skin between the scrotum and anus in the area known as the perineum, explains Mayo Clinic. Going through the wall of the rectum is known as a transrectal biopsy and is the most common of the three.
The process of a transrectal prostate biopsy begins with the patient lying on his side with his knees drawn to the chest or lying on his stomach, notes Mayo Clinic. The doctor cleans the rectum and applies gel before sliding a slender ultrasound probe inside the rectum. Sound waves create an image of the prostate, and the doctor uses those images to find the anesthetic injection site, if necessary. This image also helps the doctor decide where to place the biopsy needle. Numbing medication is usually injected to decrease any discomfort, and then the doctor uses a needle to pull out thin tissue sections. Each insertion causes brief discomfort, but the doctor generally only takes 10 or 12 samples, and the whole process is usually over in no more than 10 minutes.