Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies



Prostate biopsy

Prostate biopsy is a procedure that’s used to help diagnose prostate cancer. It involves having small samples of your prostate tissue removed, which are then sent to a laboratory for testing.

There are several types of prostate biopsy, but the most commonly performed is called a transrectal ultrasound-guided (TRUS) biopsy. This is what we’ll mainly focus on here.

An image showing the position of the prostate gland and surrounding structures


  • About prostate biopsy About prostate biopsy

    In a prostate biopsy, small samples of tissue are taken from your prostate gland. Your prostate is about the size of a walnut and lies at the base of your bladder. The back of your prostate presses against your rectum (back passage). The front of your prostate surrounds your urethra (the tube that carries urine from your bladder and out through your penis).

    There are two main types of prostate biopsy.

    • Transrectal ultrasound-guided (TRUS) biopsy – this is the most commonly used. An ultrasound probe is inserted into your rectum to produce a scan of the prostate. Directed by the scan, your doctor then takes a number of small biopsies through the probe using a needle. They’ll first inject some local anaesthetic to numb the area around the prostate. The procedure usually only takes about 20 minutes and you can go home afterwards.
    • Transperineal biopsy. If your doctor recommends this test they’ll explain why. It may be because you’ve had a negative TRUS biopsy but they think there’s still a chance you have prostate cancer. In this procedure, your doctor will insert biopsy needles through the skin in the area between your testicles and rectum (your perineum). They’ll insert an ultrasound probe into your rectum to help guide them to the right spot. You’ll have either a spinal anaesthetic, so you’ll be numb from the waist down, or a general anaesthetic, so you’ll be asleep. You may be able to go home the same day.

    This article focuses on the TRUS biopsy, as this is the type you’re most likely to have. If your doctor recommends you have a transperineal biopsy they’ll be able to answer any questions you have about that procedure. You can also look at the information on the websites of the organisations listed below. See our section ‘other helpful websites’.

  • Why have a prostate biopsy? Why have a prostate biopsy?

    A prostate biopsy will help to find out whether or not you have prostate cancer. It can also help your doctor decide on the best kind of treatment to offer you. Your doctor will probably do two tests before recommending you have a prostate biopsy.

    The first of these is a blood test to find out your level of a substance called prostate specific antigen (PSA). PSA is made by both healthy and cancerous cells in your prostate. If you have a high level of PSA, it may indicate that you have prostate cancer. However, a high PSA level doesn’t always mean that you have cancer. Bear in mind that more often it’s caused by other, less serious prostate diseases and infections.

    The second test is a digital rectal examination to check the size of your prostate. This involves your doctor inserting a finger into your rectum to feel your prostate through your rectal wall (they will wear gloves). If your doctor thinks it’s harder than usual or knobbly, they may recommend that you have a prostate biopsy. (You can find out about having this examination in our article on prostate problems.)

    As well as the results of these tests, your doctor will take into consideration other things that may affect your risk of prostate cancer. These include your age, your ethnicity and whether other close relatives have had prostate cancer.

    Ask your doctor about the advantages and disadvantages of having a prostate biopsy in your particular circumstances. You may want to read our FAQ below on the accuracy of prostate biopsy for more information.

  • Preparation Preparing for a prostate biopsy

    A transrectal ultrasound-guided (TRUS) prostate biopsy is usually done in hospital or an outpatient clinic as a day-case procedure. This means you have the procedure and go home the same day. You can eat and drink as normal before you have the biopsy.

    If you take medicines to prevent blood clots (anticoagulants), such as warfarin, aspirin or clopidogrel you should tell your doctor before the biopsy. You may need to stop taking them before you have a biopsy because they could increase your risk of bleeding after the procedure. Your doctor will tell you whether you should stop your medicines, and for how long. Don’t stop taking them without checking with your doctor. If you’re unsure about taking any of your medicines, contact your hospital.

    Your doctor will give you antibiotics before the biopsy to help prevent any infection. You may also be prescribed antibiotics to take for a few days after the procedure. Always read the patient information leaflet that comes with your medicine carefully. If you have any questions about your medicines or how to take them, ask your pharmacist.

    Your doctor will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to ask questions so that you understand what will be happening. You don’t have to go ahead with the procedure if you decide you don’t want it. Once you understand the procedure and if you agree to have it, your doctor will ask you to sign a consent form.

    Bupa On Demand

    Want to talk to a Bupa consultant? We’ll aim to get you seen the next day.

  • Alternatives What are the alternatives to a prostate biopsy?

    A prostate biopsy helps your doctor find out if you have prostate cancer. It’s usually recommended if a blood test shows a high PSA level or your prostate feels abnormal when you have a rectal examination. See our section on ‘why have a prostate biopsy?’ above for more information.

    The alternative to having a prostate biopsy may be for your doctor to keep an eye on you, and to have repeat blood tests.

    Your doctor might also recommend that you have an MRI scan of your prostate. Doctors now think this type of scan may be able to help decide if you have a cancer that needs treating.

    Ask your doctor to discuss the pros and cons of having a prostate biopsy in your particular circumstances.

  • The procedure What happens during a prostate biopsy?

    You’ll be given a local anaesthetic to ease any discomfort. So you’ll stay awake during the procedure but pain will be blocked from your rectal area.

    The procedure usually takes up to 20 minutes.

    You’ll need to change into a hospital gown that opens at the back. Your doctor will ask you to lie on your left side with your back to them and with your knees drawn up towards your chest.

    Your doctor will carefully pass a lubricated ultrasound sensor through your anus and into your rectum. The sensor may be covered with a condom. Let your doctor know beforehand if you’re allergic to latex so they can use an alternative type. The sensor may feel uncomfortable but shouldn’t be painful. Images of your prostate will be displayed on a monitor. Your doctor will use the images as a guide when they take biopsies of your prostate through the wall of your rectum.

    Before your doctor takes a biopsy, they’ll give you an injection of local anaesthetic around your prostate. Your doctor will then pass a biopsy needle down the shaft of the ultrasound sensor and collect several samples of prostate tissue. The biopsy needle is spring-loaded and will make a loud noise each time it’s fired, so you need to be prepared for this. You may find having the biopsies taken slightly uncomfortable but try to keep still. After the procedure, your tissue samples will be sent to a laboratory for testing.

  • Bupa On Demand

    Discover how you can access a range of private treatments on a pay-as-you-go basis with Bupa On Demand.

  • Aftercare What to expect after a prostate biopsy

    After your prostate biopsy you’ll usually need to stay at the hospital for at least 30 minutes, to make sure you’ve recovered from the anaesthetic.

    Your doctor or nurse will give you antibiotics to take and a date for a follow-up appointment. They should also give you information about who you should contact if you have problems in the first few days after your biopsy.

    Make sure you arrange for someone to take you home. It’s good to have someone to stay with you for a day or so after the procedure.

  • Recovery Recovering from a prostate biopsy

    If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine carefully. If you have any questions, ask your pharmacist for advice.

    Take it easy at home for a couple of days and then you should be fine to get back to your usual activities. Drink plenty of fluids during this time – perhaps twice as much as you normally would.

    It’s normal to have some blood in your urine, faeces (stool) and semen after this sort of biopsy so don’t be alarmed if you do. This will last from a few days (in your urine) to up to six weeks (in semen).

    If you’ve been given them, it’s important that you complete your course of antibiotics – usually three days – to help prevent an infection.

    Contact your GP, or the hospital (or if out of hours the hospital emergency department) if you have:

    • severe pain or pain that lasts for more than two days
    • difficulty going to the toilet (urinating)
    • a burning sensation when you go to the toilet, or if your urine starts to smell
    • increasing amounts of blood in your urine or faeces
    • a high temperature

    If you get a high temperature, and especially if it comes with uncontrollable shivers and chills, seek urgent medical attention. You may have an infection and need stronger antibiotics.

  • Side-effects Side-effects of a prostate biopsy

    Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Common side-effects of a transrectal ultrasound-guided prostate biopsy include:

    • some discomfort or pain in your rectal area. If the pain is severe or gets worse contact your GP or the hospital.
    • a small amount of blood in your urine, faeces or semen. This may last a few days in your urine. It may take weeks for blood to disappear from your semen. If you have severe bleeding or are passing clots contact your GP or the hospital.
  • Complications Complications of a prostate biopsy

    As with every procedure, there are some risks associated with transrectal ultrasound-guided (TRUS) prostate biopsy. Complications are when problems occur during or after the procedure, and include the following.

    • Your biopsy may need to be repeated. This could be because the original biopsy didn’t provide good enough samples to show if you have cancer or not. It could also be because your prostate specific antigen (PSA) level continues to rise even though your initial biopsy shows no cancer.
    • An infection. Your doctor will prescribe you antibiotics to treat the infection. If left untreated it can become severe and you’ll need to be admitted to hospital. So it’s important to seek medical attention if you get a high temperature, especially with chills and shivers.
    • Difficulty urinating. This can happen if you have a blockage in your urethra caused by a blood clot or because your prostate is swollen. If you have difficulty urinating after your biopsy, make sure you get medical attention straight away.

    The chance of any of these happening is different for everyone. Ask your doctor to explain how these risks may apply to you.

  • FAQ: Getting the result When will I find out the result of my biopsy?

    When you have your biopsy your doctor or nurse will tell you when and how you will get the results. We know that waiting for your results can be worrying, but it takes some time for the laboratory scientists to examine your biopsy samples carefully. Your results should be ready within about two to three weeks and will usually be sent to the doctor who requested your biopsy. If necessary, your results will be discussed by a team of doctors and other cancer experts at the hospital (the multidisciplinary team, MDT).

    Your doctor will go through the results with you at your follow-up appointment, answer any questions you have and discuss with you what happens next.

  • FAQ: Accuracy of a prostate biopsy How accurate is a prostate biopsy?

    A transrectal ultrasound-guided (TRUS) prostate biopsy is used to detect prostate cancer. But no diagnostic test is ideal. There are two main issues to think about with a prostate biopsy. Sometimes the biopsy will miss cancers in your prostate gland. And sometimes the biopsy will find a cancer, but it’s one that wouldn’t have actually caused you any problems in your lifetime.

    Your doctor will take 10 to 18 samples to see if you have cancer. But the biopsy can only show if there’s cancer in the tissue samples taken. If no cancer is found in the samples (a ‘negative’ result) it doesn’t definitely mean that no cancer is present at all. There could be a small cancer that the needles didn’t reach. As many as one in five prostate tumours may be missed by a TRUS prostate biopsy.

    If your biopsy doesn’t find a cancer, your doctor may continue to monitor your prostate with further prostate specific antigen (PSA) tests. If your PSA continues to rise, your doctor may recommend you have another biopsy to see if a cancer was missed the first time. Alternatively (or as well as), you may be offered an MRI scan.

    Just because you have cancer in your prostate doesn’t mean it will always cause problems in your lifetime. You may have a slow growing or non-aggressive cancer. Prostate biopsy may find one of these cancers. Finding out that you have this type of prostate cancer may not be the best thing for you. You may have treatment, and that can have side-effects. These side-effects may, for some men, be worse than the effects of the cancer itself.

    Taking all this into account, it’s your decision whether to go ahead and have a biopsy done. Ask your doctor to explain the pros and cons of having a prostate biopsy in your particular circumstances.

  • FAQ: Sex after a prostate biopsy How soon after a prostate biopsy can I have sex?

    This is something that you should ask your doctor when you have your biopsy. They may advise you to wait for a few days before you have sex. There are no hard and fast rules.

    You may have some blood in your semen for up to six weeks after your biopsy. This won’t cause any harm to you or your partner.

  • FAQ: Exercise after a prostate biopsy How soon can I exercise after a prostate biopsy?

    You may have a little pain and discomfort in your rectal area after having a prostate biopsy. So it’s best to sit quietly at home for the first two days afterwards. As long as you don’t have complications you should be able to resume your usual activities then.

    When you have your biopsy, ask your doctor about resuming your exercise and sporting activities. They’ll be able to discuss with you what’s best in your particular circumstances. If you have more pain or bleeding after exercising, contact your GP.

  • Resources Resources

    Further information


    • Prostate cancer. BMJ Best Practice., last updated 23 February 2017
    • Prostate Biopsy Technique. Medscape., updated 25 April 2016
    • Prostate anatomy. Medscape., updated 16 September 2013
    • Map of Medicine. Prostate Cancer. International View. London: Map of Medicine; 2017 (Issue 1)
    • Transrectal prostatic ultrasound and biopsy. The British Association of Urological Surgeons., published March 2016
    • Transperineal biopsy of the prostate. The British Association of Urological Surgeons., published March 2016
    • Prostate biopsy. Prostate Cancer UK., updated July 2016
    • The PSA test. Prostate Cancer UK., updated November 2016
    • Digital rectal examination (DRE). Prostate Cancer UK., updated November 2016
    • Ultrasound guided prostate biopsy. Royal Australian and New Zealand College of Radiologists., page last modified 26 September 2016
    • Ahmed H, El-Shater Bosally A, Brown, L, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017; 389:815–22. doi:10.1016/S0140-6736(16)32401-1
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
  • Related information Related information

  • Author information Author information

    Reviewed by Dr Kristina Routh, Freelance Health Editor, May 2017
    Expert reviewer, Professor Raj Persad, Consultant Urological Surgeon
    Next review due, May 2020

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content

  • Dylan Merkett – Lead Editor
  • Graham Pembrey - Lead Editor
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Specialist Editor, Insights
  • Natalie Heaton – Specialist Editor, User Experience
  • Fay Jeffery – Web Editor
  • Marcella McEvoy – Specialist Editor, Content Portfolio
  • Alice Rossiter – Specialist Editor (on Maternity Leave)

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.


In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.


We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.


We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: Or you can write to us:

Health Content Team
Battle Bridge House
300 Grays Inn Road

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.