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Prostate Biopsy Procedures in California

Medically reviewed by: Dr. Prithipal S. Sethi, MD of Golden State Urology
Dr. Sethi is a board-certified urologist with more than 25 years of experience. A recognized leader in prostate health, he specializes in prostate diagnostics and advanced treatments for prostate conditions.

If you’ve been advised to undergo a prostate biopsy, it’s normal to have questions and concerns.

We understand that the process can feel overwhelming, but early detection is key to effective treatment. Our team is here to provide you with the information and support you need to feel confident, prepared, and at ease.

Prostate Biopsy Procedures in California

What to Know Before a Prostate Biopsy

What Is a Prostate Biopsy?

A prostate biopsy is a procedure where small samples of prostate tissue are collected to check for signs of prostate cancer or other abnormalities.

Why Are Prostate Biopsies Performed?

Prostate biopsies are performed when someone has symptoms that may indicate prostate cancer, such as elevated prostate-specific antigen (PSA) levels or an abnormal digital rectal exam (DRE).

How Is a Prostate Biopsy Done?

There are a few types of prostate biopsy, each using a different approach to access the prostate and gather tissue samples. Your doctor may recommend a specific type based on your health, prostate anatomy, or previous test results.

Transrectal Prostate Biopsy

This approach involves inserting an ultrasound-guided needle through the rectum to retrieve tissue samples. The procedure typically takes 20–30 minutes and is minimally invasive.

What to Expect

Pre-Appointment:

You may be instructed to stop taking certain medications, such as blood thinners.
You will be prescribed antibiotics to reduce the risk of infection and possibly an enema to clear the rectum for better access.

During the Procedure:

You will lie on your side with your knees pulled up to your chest.
A thin lubricated ultrasound probe will be inserted to guide the biopsy needle. You will feel some pressure, which could be uncomfortable.
A local anesthetic may be used to numb the tissue before inserting the biopsy needle. You will feel a brief sting as this occurs.

After the Procedure:

You will have time to recover, and we will provide detailed aftercare instructions and information on next steps.

Transperineal Prostate Biopsy

In some cases, we may perform a more targeted prostate biopsy called a transperineal biopsy. This relatively new prostate biopsy procedure involves accessing the prostate through the skin between the anus and scrotum, offering a low infection risk and greater precision.

What to Expect

Pre-Appointment:

You may be asked to stop certain medications and take antibiotics.

During the Procedure:

You’ll be positioned comfortably, often on your back with legs elevated.
A local anesthetic will be administered to numb the perineum. Mild sedation may also be offered for comfort.
An ultrasound wand will be inserted into the rectum for guidance.
Your doctor will insert a fine biopsy needle through the perineum to collect small tissue samples (typically 10-12).

After the Procedure:

You’ll be monitored briefly and given aftercare instructions.

MRI Fusion Prostate Biopsy

An MRI fusion biopsy combines pre-recorded MRI images with real-time ultrasound to guide the needle. This method is more accurate than ultrasound-guided biopsies, allowing better targeting of suspicious areas.

What to Expect

Pre-Appointment:

You will be referred to a radiology center for an MRI scan to identify any suspicious areas within the prostate.
Antibiotics will be prescribed, and you will be asked to halt certain medications, such as blood thinners.

During the Procedure:

You’ll be comfortably positioned on the exam table. A sedative may be administered for relaxation.
A lubricated ultrasound wand will be inserted into the rectum. You may feel some pressure, which could be uncomfortable.
A local anesthetic will numb the biopsy area before taking tissue samples.
Our team will use software to fuse MRI images with ultrasound images to guide the biopsy needle to the exact spots identified in the MRI scan.

After the Procedure:

You’ll receive aftercare instructions and have the opportunity to ask any questions.

MRI-Guided Prostate Biopsy

An MRI prostate biopsy is guided by continuous MRI imaging, typically used to target areas that may be difficult to access with an ultrasound biopsy.

What to Expect

Pre-Appointment:

You will be referred to a radiology center for an MRI scan to identify any suspicious areas within the prostate.
Antibiotics will be prescribed, and you will be asked to halt certain medications, such as blood thinners.

During the Procedure:

You’ll be comfortably positioned on the exam table. A sedative may be administered for relaxation.
A lubricated ultrasound wand will be inserted into the rectum. You may feel some pressure, which could be uncomfortable.
A local anesthetic will numb the biopsy area before taking tissue samples.
Our team will use software to fuse MRI images with ultrasound images to guide the biopsy needle to the exact spots identified in the MRI scan.

After the Procedure:

You’ll receive aftercare instructions and have the opportunity to ask any questions.

Questions About Your Prostate Biopsy?

We understand that medical procedures like this can be intimidating. If you have questions, please don’t hesitate to contact us.

You can call our office at 916-245-8888 to speak with a member of staff.

What If My Prostate Biopsy Is Abnormal?

If your biopsy results indicate abnormal findings, such as cancerous or precancerous cells, your doctor will discuss the details with you and refer you for further testing.

This may include imaging scans or additional biopsies to clearly show the extent and aggressiveness of any abnormal cells.

After a diagnosis is established, your doctor will work with you to develop a tailored treatment plan.

Prostate Cancer: What to Know

Statistics from the American Cancer Society indicate that 1 in 8 men will be diagnosed with prostate cancer during their lifetime, with some populations at a higher risk:

Men over 50
Men with a family history of prostate cancer
Men of African or Caribbean descent

Though any cancer diagnosis is serious, it may be reassuring to know that the majority of men diagnosed with prostate cancer do not die from it. Prostate cancer is highly treatable—especially when detected early.

Treatment options vary based on the diagnosis. Options include active surveillance for slow-growing cases and advanced therapies like surgery, radiation, and hormone treatments. Many men with prostate cancer lead full, healthy lives. Your doctor will work with you to develop the best treatment plan tailored to your specific situation.

WHY GOLDEN STATE UROLOGY?

Golden State Urology is a leading urology practice serving men and women in the Sacramento area.

We are proud to offer timely, compassionate, personalized care to our patients, and have a long history of success in minimally invasive urologic procedures and treatments.

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Prostate Biopsy FAQs

How accurate is a prostate biopsy in detecting prostate cancer?le

A prostate biopsy is generally quite accurate in detecting prostate cancer, but detection can vary depending on the biopsy technique used and the number of samples taken.

Studies indicate that MRI-guided biopsies are significantly more effective at detecting aggressive prostate cancers compared to traditional methods. This approach misses only about 14% of cancers, compared to around 40% when using an ultrasound-guided biopsy.

MRI biopsy vs. ultrasound biopsy: which one do I need?

An MRI-guided biopsy utilizes detailed MRI images to precisely target suspicious areas, offering improved accuracy in detecting cancerous cells. This method is generally used if previous biopsies were inconclusive or if you’re at higher risk.

An ultrasound-guided biopsy is more common and widely available. It uses real-time ultrasound images to guide the biopsy. Though not as detailed as MRI, it’s effective for initial evaluations.

Your doctor will recommend the best approach based on your specific health needs.

How do they do a prostate biopsy?

A prostate biopsy collects small tissue samples using a thin needle guided by an ultrasound probe or MRI. After numbing the area, the doctor uses a biopsy needle to retrieve samples. The procedure can take between 20 minutes and an hour, depending on the method used. After the biopsy, the tissue is sent to a lab for analysis.

What are the risks or side effects associated with a prostate biopsy?

While a prostate biopsy is generally safe, it does carry potential risks and side effects like any medical procedure. Common side effects include mild bleeding in urine, stool, or semen, and temporary discomfort at the biopsy site. There’s a small risk of infection, which is minimized with antibiotics.

In rare cases, patients may experience temporary urinary difficulties, allergic reactions to medications, or serious infections. These risks are typically low and manageable, and our team will provide aftercare instructions to ensure a smooth recovery.

How long does the prostate biopsy procedure take?

The procedure itself typically lasts between 15 and 45 minutes. However, additional time is needed for preparation and brief recovery in-office. Since it’s typically done on an outpatient basis, you can go home the same day. You will also need to rest for about 24 hours after the procedure, so be sure to make arrangements accordingly.

How long does it take to receive biopsy results?

Biopsy results are typically available within a few days to a week, depending on how long it takes the lab to analyze your samples. Our team will reach out as soon as the results are ready to arrange a follow-up appointment to discuss your results and any next steps.

What does a prostate biopsy detect besides cancer?

The primary purpose of a prostate biopsy is to detect prostate cancer; however, it can also identify other conditions, such as inflammation (prostatitis) or benign prostatic hyperplasia (BPH).

How should I prepare for a prostate biopsy?

To prepare for a prostate biopsy:

Inform your provider of any allergies, medications, supplements, and bleeding disorders, especially if you’re taking blood thinners or aspirin. You may be asked to stop taking certain medications that could interfere with the procedure.
You likely will not need to fast, but you may need an enema if the transrectal method is used.
You might receive a sedative, in which case you may need to arrange for a ride home.
Antibiotics will likely be prescribed starting the day before to prevent infection.

How often should I have a prostate biopsy if I have elevated PSA levels?

The frequency of prostate biopsies for elevated PSA levels varies. Your doctor will consider PSA trends, family history, and other risk factors when determining your biopsy schedule.