After screening for prostate cancer, a doctor might recommend a prostate biopsy. This minimally invasive procedure involves a surgeon removing samples of tissue from your prostate and sending them to a lab for analysis. This analysis can help determine if there are cancer cells present.

A prostate biopsy is typically an outpatient procedure. That means you usually won’t have to stay in the hospital overnight. Still, recovery often requires you to make some minor lifestyle changes for a week or two.

Let’s cover what you need to know about prostate biopsies, what to expect during the procedure and recovery, and some tips to help you along.

How long does it take to recover from a prostate biopsy?

Recovery from a prostate biopsy usually takes a few days.

The surgeon will likely recommend that you avoid any exercise or strenuous activity for up to 5 days after the procedure to reduce the risk of injury or complications.

You may also need to take antibiotics for up to 3 days afterward to help prevent infections.

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Some of the effects you experience after a biopsy may depend on the type of biopsy you have. So, first, let’s look at the different types of prostate biopsies.

There are three types of prostate biopsies doctors use to remove tissue samples from your prostate for lab analysis:

  • transrectal biopsy
  • transperineal biopsy
  • transurethral biopsy

The surgeon will use an ultrasound tool to view the area around your prostate. They’ll also use a local anesthetic around the area to reduce pain. Guided by the ultrasound, the surgeon will use a needle to remove multiple tissue samples from your prostate gland.

In a transurethral biopsy, the surgeon uses a scope (thin, lighted tube with a camera) instead of an ultrasound. The scope goes through your urethra and has a tool to help the surgeon remove the tissue samples.

A prostate biopsy is a relatively low risk procedure. But there is some risk of adverse effects. These side effects are usually short-term and involve bleeding due to the needle or tools perforating the area around your prostate.

You may notice blood in your:

  • rectum the first few days after your biopsy, and it may be difficult to stop the bleeding
  • semen for a few weeks that may noticeably discolor the fluid
  • pee or poop for a few days, but this bleeding may extend up to a week or two

You may also have trouble peeing for a few days, especially after a transurethral biopsy. In some cases, the surgeon may insert a catheter to help you pee in the early stages of recovery.

About 3% of people need to go back to the hospital after a prostate biopsy, usually due to an infection. A doctor may prescribe you antibiotics to prevent this. According to a 2015 research review, you’ll usually take them for 1 or 3 days.

According to 2019 research, you may have a lower risk of infection or bleeding if you have a transperineal biopsy. Still, this method comes with other risks, such as urinary incontinence and risks from getting a general anesthetic.

When to contact a doctor

Get medical attention right away if you notice any of the following symptoms after a prostate biopsy:

  • a fever that rises above 101°F (38°C)
  • rectal bleeding that won’t stop
  • a large amount of blood in your pee
  • dark blood or clots in your pee that don’t go away after a few weeks
  • trouble peeing or pooping
  • unusual or severe pain when you pee or poop
  • skin reactions to medication, such as a rash

Your doctor may ask you to refrain from certain activities. Typically, they may suggest that you:

  • Avoid strenuous activity, especially exercises like running, biking, or swimming.
  • Do not lift anything higher than 10 pounds for the first 24 hours.
  • Avoid straining too hard when you poop while your body is recovering. Use a stool softener if you’re having trouble passing a bowel movement.
  • Do not have sex or masturbate for the first 48 hours.

The results from your prostate biopsy will usually be available within 1 to 3 days, but it can take up to a week. A doctor will schedule a follow-up with you to discuss your results and any next steps.

Sexual activity after a prostate biopsy

Let the area heal for a few days before you have sex or masturbate. This will allow enough time for the affected area to recover.

You may also want to wear condoms for a week or two to help prevent bacteria or other substances from irritating the areas around your rectum, perineum, or urethra.

You may notice that your semen has a slight reddish or dark discoloration for a few weeks after a prostate biopsy. This is because blood can get into your semen, which the prostate gland makes to help carry sperm from the testicles.

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Here are some ways you can help reduce your recovery time before and after your prostate biopsy:

  • Stop taking blood thinners like aspirin or warfarin to help promote blood clotting during healing.
  • Take any antibiotics a doctor instructs you to take before and after the biopsy.
  • Use any enemas that a doctor instructs you to take to clean out your rectum and reduce your risk of infection.
  • Consider giving a urine sample before the biopsy so that the doctor can ensure you don’t have a urinary tract infection.
  • Rest for a few days after the biopsy and try to stay off your feet to prevent irritation at the biopsy site.
  • Consider taking a few days off work or other activities to reduce stress and movement.
  • Reduce stress or anxiety to keep your body calm and promote your immune system function.
  • Drink about 64 ounces of water a day to hydrate and promote healing.
  • Avoid caffeine and alcohol, which can thin your blood, interfere with antibiotics, and make you pee more frequently.

A prostate biopsy is the most accurate tool a doctor can use to confirm a diagnosis of prostate cancer.

But you may not always need a prostate biopsy. Here are a few other tests that a doctor might recommend during a regular prostate cancer screening to rule out cancer without doing a biopsy:

  • Digital rectal exam (DRE): During a DRE, a doctor will insert a gloved finger into your rectum to feel your prostate.
  • Prostate-specific antigen (PSA) test: A PSA test analyzes your blood for levels of the PSA protein. High levels could indicate prostate cancer.
  • Transrectal ultrasound (TRUS): A doctor may use TRUS to look at the prostate gland through your rectum, using an ultrasound machine to check for tumors or other abnormalities.
  • Urine test: A urine test can detect other signs of prostate cancer in your pee, such as genetic markers that may indicate your risk.
  • PET scan: A 2022 analysis suggested that a PET scan using a specific tracer can detect prostate cancer without a biopsy. But research is ongoing, and this is not yet a standard procedure.

How effective are prostate biopsies at identifying cancer?

Prostate biopsies are the most accurate tools for diagnosing prostate cancer, especially when doctors use them with other screening tests.

But that doesn’t mean they’re perfect. For example, a transrectal biopsy can misclassify up to 50% of prostate cancer cases.

There’s also a 16% to 40% chance of a false negative. That means the biopsy can miss the cancer.

The use of newer techniques like MRI and PET scans can improve accuracy.

Some newer urine tests may also prove to be more accurate than biopsies. A 2021 study showed that the MyProstateScore test was highly accurate in detecting cancer in 1,525 people. The study showed that the test would have prevented 387 unnecessary biopsies.

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A prostate biopsy is a quick, low risk procedure with a short recovery time. It’s one of the most accurate tools for detecting prostate cancer.

During your recovery, you can expect certain side effects, especially blood in your urine or semen. A doctor may prescribe antibiotics in advance to help prevent infection. You may need to hold off on strenuous activities for a few days, including exercise and sex.

You’ll usually have your biopsy results in a few days. If the results indicate cancer, talk with your doctor to learn more about your diagnosis and what your next steps might be. When caught early, prostate cancer is typically easy to treat and manage.