TRUS Guided Prostate Biopsy
Section 1: The Basics
Q: What is a TRUS Biopsy? A: TRUS stands for Transrectal Ultrasound.
The Ultrasound: We place a small ultrasound probe into the rectum to create an image of your prostate.
The Biopsy: Using this image as a guide, we use a thin needle to take tiny tissue samples (cores) from the prostate. These samples are sent to a lab to check for cancer cells.
Q: Why do I need this test? A: Your urologist likely recommended this because:
Your PSA (Prostate-Specific Antigen) blood test levels are elevated or rising.
A lump or irregularity was felt during a digital rectal exam (DRE).
An MRI scan showed a suspicious area in the prostate.
Q: Is this a surgery? A: No. It is a diagnostic procedure done in the office or clinic. There are no incisions or stitches.
Section 2: Preparation
Q: Do I need to stop my medications? A:
Blood Thinners: Yes. This is critical. You typically need to stop medications like Aspirin, Clopidogrel, Warfarin, or Eliquis for 5–7 days before the procedure to prevent bleeding. Always confirm the exact timing with us.
Other Meds: You can take your blood pressure or heart medications as usual.
Q: Do I need antibiotics? A: Yes. Because the needle passes through the rectum, there is a risk of infection. We will prescribe an antibiotic for you to take before and sometimes after the procedure. Taking this exactly as directed is the most important step to prevent complications.
Q: Do I need to do an enema? A: Yes. We usually ask you to perform a simple fleet enema at home 1–2 hours before your appointment. This clears the rectum to give us a clear view on the ultrasound and reduces infection risk.
Section 3: The Procedure (What to Expect)
Q: Will it hurt? A: Most men feel pressure, but not sharp pain.
Anesthesia: We inject a local anesthetic (numbing block) around the prostate nerves before we start. This significantly reduces discomfort.
The Sensation: You will feel the pressure of the ultrasound probe (similar to a rectal exam). When the biopsy is taken, you may hear a loud "clicking" or "snapping" sound from the device and feel a brief pinch or tap.
Q: How long does it take? A: The actual procedure only takes about 10 to 15 minutes.
Q: Can I drive myself home? A: Yes. Since we use local anesthesia (numbing only), you will be fully awake and can drive yourself home immediately after.
Section 4: After the Biopsy (Recovery)
Q: Will I see blood afterward? (Important) A: Yes, this is very common and expected.
Urine: You may see pink or red urine for 3–5 days.
Stool: You may notice a small amount of bleeding from the rectum for 1–2 days.
Semen: Your semen may look rust-colored or dark brown. Do not panic. This is old blood clearing out. It can last for 4 to 6 weeks after the biopsy. It is not harmful to you or your partner.
Q: Can I return to work? A: Yes. You can return to office work or light activities the same day. Avoid heavy lifting or strenuous exercise (gym, cycling) for 3 days to minimize bleeding risk.
⚠️ When to Call the Doctor
While complications are rare, infections can be serious. Go to the nearest Emergency Room immediately if you experience:
Fever: Any temperature over 100.4°F (38°C). This is a sign of sepsis (infection in the blood) and requires urgent IV antibiotics.
Chills: Uncontrollable shaking or shivering (rigors).
Urinary Retention: You have a full bladder but cannot urinate.
Heavy Bleeding: Passing large clots in your urine or filling the toilet bowl with blood from the rectum.