A transperineal prostate biopsy is one way a healthcare professional can take a tissue sample from your prostate to test for prostate cancer. Research suggests it may be safer than other methods.

A prostate biopsy is a necessary step in the diagnosis of prostate cancer. It involves a urologist taking a small sample of prostate tissue for analysis in a lab.

In a transperineal prostate biopsy, a urologist inserts a needle through your perineum — the small area of skin between your anus and your genitals — to remove the sample.

This type of prostate biopsy has lower risks than other types, making it a preferred method for quickly and easily getting a tissue sample to test for prostate cancer.

Read on to learn more about when you might need a transperineal prostate biopsy, what to expect before and after the procedure, and how it compares with other types of prostate biopsy techniques.

A transperineal prostate biopsy is a diagnostic test for prostate cancer.

A urologist typically does this by removing a small sample of cells from the prostate gland — a walnut-sized gland that sits inside your pelvis, between your genitals and your rectum — using a technique called fine-needle aspiration. It’s mostly painless and quick.

They may also use a prostate ultrasound to locate the prostate and successfully insert the needle into the prostate without damaging any tissues around it.

Along with blood tests, a transperineal prostate biopsy is one of the essential tests in diagnosing prostate cancer.

This type of biopsy can also help rule out prostate cancer and help diagnose other prostate conditions, such as benign prostatic hyperplasia.

A transperineal prostate biopsy takes place in an outpatient treatment center. That means you won’t have to check into the hospital or stay overnight. The procedure takes around 10 to 15 minutes.

The procedure for a transperineal prostate biopsy typically goes as follows:

  1. The urologist inserts a small, lubricated ultrasound device into your rectum to show the prostate gland and the tissues around it.
  2. Using a small needle, they inject a pain medication like lidocaine into the perineum.
  3. Once the perineum is numb, the urologist lifts your scrotum and inserts a small needle into the perineum until they can see that it’s reached the prostate on the live ultrasound image.
  4. They may insert the needle into several areas in the prostate called lobes that may be at risk of containing cancerous cells. They may take anywhere between 12 and 18 samples from different lobes.
  5. The urologist slowly removes the needle and transfers the tissue samples into sterile containers filled with formalin. They then send the samples to a lab for analysis.

A transperineal prostate biopsy has very few risks.

Some possible risks or side effects associated with this type of biopsy include:

  • pain or discomfort in the perineum after the biopsy
  • bruising at the needle insertion site
  • a small amount of blood in your urine or semen
  • an allergic reaction to the lidocaine or the needle
  • minor injury to the urethra or the tissues around the prostate
  • trouble peeing for a short time
  • temporary symptoms of erectile dysfunction

You don’t need to do anything to prepare your body for a transperineal prostate biopsy.

Sitting may be uncomfortable or painful afterward, so consider taking some time off your regular activities, like working at a desk or lifting heavy objects. If you can, ask a family member or friend to drive you home from the procedure, especially if you’re having a sedative or anesthetic.

The urologist may also ask you to have MRI imaging of the prostate before a transperineal prostate biopsy. This imaging test provides them with detailed, multidimensional images that can help them prepare for the procedure by examining your prostate for signs of cancer.

You may have some pain or discomfort in your perineum after a transperineal prostate biopsy when the sedative or anesthetic wears off.

Ask someone to drive you home so that you can avoid sitting for a long time, which can make the area feel more painful or uncomfortable. When you get home, you can use a cold compress to help relieve pain or swelling.

You should only feel the side effects of a transperineal prostate biopsy for a few days before they go away. Contact a doctor if you experience any bleeding, swelling, or pain that doesn’t get better.

Urologists often prefer transperineal prostate biopsies over transrectal or transurethral biopsy methods.

A transrectal prostate biopsy involves a urologist inserting the needle through the wall of your rectum to reach the prostate gland.

It used to be the preferred biopsy technique, but healthcare professionals are increasingly preferring transperineal biopsy. A 2019 study found that the techniques were similarly accurate, but the risk of infection and rectal bleeding was higher with transrectal biopsies.

A transurethral prostate biopsy involves inserting the needle through your urethra — the tube that drains urine from your bladder through your penis — to reach the prostate. The tissues within the urethra are very delicate, so a transurethral biopsy can be more uncomfortable and increase your risk of a urinary tract infection (UTI).

How long does a transperineal prostate biopsy take?

A transperineal prostate biopsy usually takes about 10 to 15 minutes.

How painful is a transperineal prostate biopsy?

You’ll likely receive a local anesthetic before a transperineal prostate biopsy, so you shouldn’t feel much pain during the procedure.

You might experience some mild or moderate pain or discomfort in the first few days after the biopsy, but the pain will eventually go away on its own.

Can you drive after a transperineal prostate biopsy?

Confirm with your healthcare professional whether you’ll be OK to drive home after a transperineal prostate biopsy. You might not be able to drive if the sedative or anesthetic that the healthcare professional used takes a while to wear off.

Driving may increase your pain or discomfort, so consider asking someone you know and trust to drive you home.

A transperineal prostate biopsy is a quick, safe, and effective procedure. Urologists do these to remove a tissue sample from your prostate gland and confirm a diagnosis of prostate cancer.

This type of biopsy is usually safer than other common types of prostate biopsies done through the rectum or urethra. Talk with a healthcare professional about this method if you need a prostate biopsy for a prostate cancer diagnosis.