The instructions, and warning regarding either a trans-rectal prostate biopsy (standard) done in the office or a saturation biopsy (done in special circumstances) done in an outpatient surgical center are identical.
The preparation for a prostate biopsy is:
- You will be asked to take a three day course of antibiotics, typically ciprofloxacin (twice-a-day) or levaquin (once-a-day) starting the day before a prostate biopsy. These will be either provided for you in our office when scheduling or via a prescription given to you. Additional antibiotics may be administered in the office by our nurse.
- You will be asked to self-perform a “Fleet’s” enema or equivalent in the morning of your biopsy at home prior to coming to have the biopsy performed.
- Blood thinning medications such as aspirin and coumadin-like drugs or even herbal medications must be stopped sufficiently ahead of time.
What to Expect for a Prostate Biopsy
Blood in the urine, semen or stool are to be expected and are not complications. Such bleeding is of no concern at all, and will nearly always eventually stop although blood in the semen can rarely last weeks.
Some men who already have trouble with urination and urinary retention may go into retention whereby they cannot empty their bladder after a prostate biopsy. Urinary retention is characterized by feeling the need to urinate but only urinating small amounts, with the need to go again soon after. If this occurs, the patient will either need to go to an emergency room to be catheterized or come to our office immediately to be evaluated.
By far the most dangerous and concerning risk of a prostate biopsy that occurs with some regularity (approximately 1%) is to develop an infection after a biopsy. This infection can rapidly progress to sepsis if not managed immediately which is a serious and potentially deadly condition. Therefore, if at any time after a prostate biopsy you feel chills or fevers, there is no choice but to go SPECIFICALLY to the George Washington or Sibley Emergency Room to be evaluated and to receive I.V. antibiotics. These infections are nearly always caused by certain bacteria that are resistant to many antibiotics that uniquely thrive in the bloodstream and trigger sepsis. Patients should not phone from home, but simply go to one of the above Emergency Rooms so that we may help you right away and apply our experience to the situation. When caught early, these infections are almost always treated successfully, but delay can have serious consequences.
We will go over your pathology results with you in person, typically three days later.