Prostate Biopsy Preparations
Your doctor has scheduled you for a prostate biopsy. Below are the instructions that you must follow.
BEFORE THE PROSTATE BIOPSY (NO LATER THAN TWO WEEKS BEFORE THE BIOPSY):
- A rectal swab will need to be performed to determine the appropriate antibiotic for your biopsy. This swab will typically be performed by your provider at the consultation or follow-up visit when they feel a biopsy should be scheduled. If the swab was not completed, please call 410-955-6100 to set up an appointment with nursing staff. We prefer for this test to be done here at our clinic, but if you are traveling or cannot feasibly make it to the clinic, it may be possible for a kit to be mailed to your home for self-administration of the test. Please contact your provider immediately if this option can be arranged for you. If you are unsure whether a rectal swab has been completed, please contact your provider.
- Please notify your provider if you have taken any course of antibiotics since the administration of the rectal swab. This can affect what antibiotic will be prescribed for the biopsy.
ONE WEEK BEFORE THE PROSTATE BIOPSY:
- You should be contacted by your provider's office with the results of the rectal swab culture and which antibiotic is best for you. If you have not been called by your doctor's office one week before the biopsy, please call them for results and instructions.
- Please purchase a Fleet Enema kit so you have it ready for the morning of the prostate biopsy.
- STOP TAKING ALL ASPIRIN AND BLOOD-THINNING PRODUCTS- FAILURE TO STOP MAY RESULT IN THE CANCELLATION OF YOUR PROSTATE BIOPSY!
Attached you will find a list of many drugs containing aspirin, ibuprofen, and blood-thinning medications that should be stopped SEVEN DAYS before your prostate biopsy. These drugs, if not stopped, can increase your risk of bleeding after the prostate biopsy.
IF YOU HAVE ANY QUESTIONS ABOUT STOPPING YOUR ASPIRIN OR BLOOD-THINNING DRUGS, OR, IF YOU DO NOT SEE YOUR DRUG ON THE LIST, PLEASE CALL YOUR UROLOGIST'S OFFICE.
***Men with a Cardiac Stent who take Aspirin or other blood thinner: please call your urologist for specific instructions.
IF YOU CANNOT KEEP YOUR APPOINTMENT PLEASE CALL 410-955-6100 TO RESCHEDULE YOUR BIOPSY
THE DAY OF THE PROSTATE BIOPSY:
- Take your antibiotic as instructed by your Urologist.
- Eat a regular breakfast and/or lunch.
- Use the Fleet Enema as directed two hours before your prostate biopsy.
- Drink plenty of fluids.
- Come to the Urology Clinic at the stated arrival time, this will be before your actual biopsy time.
** If you require intravenous antibiotics (as determined by your rectal swab) plan to arrive in clinic about 1.5 hours before your biopsy**
YOUR PROSTATE BIOPSY PROCEDUREYour preparations should all be completed and you should now be in the Urology Clinic at your scheduled arrival time. You will be registered and then seen by a member of the nursing staff, who will review your preparations (Fleet enema, prescribed antibiotic, no aspirin, etc.), record your height and weight, measure your blood pressure and pulse, and review all of your medications. Please arrive with enough urine in your bladder because you may be asked to give a urine specimen.
You will then be asked to put on a hospital gown and will be positioned on the exam table for your prostate biopsy. This position requires you to lie on your left side, with your knees drawn up to your chest. Your comfort is important to us: a pillow will be placed between your knees and under your head.
A nurse will place lidocaine jelly into your rectum. Your urologist will then inject more lidocaine to block the nerves around the prostate after insertion of the ultrasound probe into the rectum.
Your urologist will measure the size of your prostate; and if you are having an MRI/fusion biopsy the MRI and the ultrasound images will be aligned. Then, the biopsy specimens will be taken. You will hear a "click" and may feel pressure as the biopsy is performed. Your urologist may take up to 12 or more specimens depending on your particular situation. However, it takes just several minutes to complete the biopsy portion.
After the prostate biopsy is completed, the urologist may apply pressure to the rectum to control any bleeding. You will be asked to lie on your back and rest. When you are feeling ready, you will be allowed to get up, wash, and dress. Before you are discharged from the clinic, you will be asked to urinate into a specimen cup to check for bleeding. Your urologist and/or nursing staff provider will go over all of the instructions you should follow after your prostate biopsy.
AFTER YOUR PROSTATE BIOPSY
- Eat as you normally do.
- Take your prescribed antibiotics as directed.
- You may see blood in your urine (with or without clots) for 24- 72 hours. Please drink enough fluids so that your urine is clear yellow or pale pink (8-12 eight ounce glasses) to prevent more clots from forming.
- No straining or heavy lifting for 5 days after your prostate biopsy.
- You may resume aspirin when you have seen NO BLOOD IN YOUR URINE FOR THREE DAYS IN A ROW. Please ask your urologist when you can restart any other blood thinning drugs on the list.
- You may see blood in your stool for 24-72 hours.
- You may see blood in your semen when you ejaculate for 4-6 weeks, sometimes more.
WHEN TO CALL YOUR UROLOGIST
Call your urologist IMMEDIATELY if you experience any of the following:
- You cannot urinate after the prostate biopsy.
- Fever above 101 degrees (F)
- Flu-like symptoms even if you think they are unrelated to the biopsy
- Passing excessive clots in the urine and/or stool.
- Persistent blood in the urine for more than 3 days
Contact your urologist or call the Urology Clinic at 410-955-3801 between 8 am and 5 pm Monday- Friday. Otherwise, call 410-955-6070 and ask for the urologist-on-call.