Having a transrectal ultrasound scan and prostate biopsy
Information for patients from the Urology Department
You have been referred to the hospital for a transrectal ultrasound scan and prostate biopsy. This leaflet will answer the following questions.
What is a transrectal ultrasound scan and prostate biopsy?
What the alternatives are, and what happens if I choose not to have the procedure?
How do I prepare for my procedure?
What happens during the procedure?
What are the risks to having the procedure?
When can I resume my normal activities?
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.
Why do I need a transrectal ultrasound scan and prostate biopsy?
The prostate is a small gland associated with the male reproductive system. The prostate is found at the base of the bladder. It tends to enlarge with age and can block the outflow of urine.
Men do not always have symptoms from prostate disease. A blood test showing a raised PSA (prostate specific antigen) may point to a hidden problem.
This procedure will help to see whether there is any serious disease in your prostate gland, causing your abnormal PSA blood test.
Are there alternatives?
If alternatives are available to you, these will be discussed with you on the day of your procedure. The alternatives available will depend on your PSA and MRI results. Following your consultation the alternatives could be either of the following.
Observation with repeat blood tests
Repeating your blood test. We only investigate further if your prostate specific antigen (PSA) blood test level rises.
Transperineal ultrasound-guided prostate biopsy
We take multiple biopsies under either local or general anaesthetic. During this procedure, a biopsy needle is passed through your perineum. The perineum is the skin between your scrotum and anus. The biopsy needle is guided by ultrasound. The transrectal procedure has a lower risk of infection.
What are the benefits to having a transrectal ultrasound scan and prostate biopsy?
We recommend you have this procedure. It is the only procedure that will clearly find cancer. Offering the diagnosis needed before you receive further necessary treatment.
What happens if I decide not to have the procedure?
We recommend you have this procedure. It is the only procedure that will clearly find cancer. Offering the diagnosis needed before you receive further necessary treatment.
Where will my procedure take place?
You will have your procedure in the Outpatients Department at Kent and Canterbury Hospital.
Due to the nature of the examination, we are unable to accommodate unaccompanied children within the department.
How do I prepare for a transrectal ultrasound scan and prostate biopsy?
Most patients do not need to prepare for this procedure. However, if you take anticoagulants and dipyridamole we may ask you to stop taking these before your biopsy. Anticoagulants can include the following blood thinning medication:
aspirin, clopidogrel, ticagrelor, prasugrel, rivaroxaban, dabigatran, apixiban, or warfarin.
If we have told you to stop taking your medication before your biopsy, the table below will tell you when to do this. Please contact Urology on 01227 864383 if you are not sure when to stop taking your anticoagulants.
| Drug | Should I stop taking my medication? | When should I stop taking my medication before my procedure? |
|---|---|---|
| Warfarin (Coumadin) | yes | 5 to 7 days |
| Heparin | yes | 3 to 5 hours |
| Rivaroxaban (Xarelto) | yes | 48 hours |
| Dabigatran (Pradaxa) | yes | 48 hours |
| Apixaban (Eliquis) | yes | 48 hours |
| Edoxaban (Savaysa) | yes | 48 hours |
| Enoxaparin (Lovenox) | yes | 6 hours |
| Fondaparinux (Arixtra) | yes | 48 hours |
| Aspirin | yes | 12 hours |
| Clopidogrel (Plavix) | yes | 7 days |
| Prasugrel (Efient) | yes | 7 days |
| Dipyridamole / aspirin (Aggrenox) | yes | 3 days |
| Ticlopidine (Ticlid) | yes | 7 days |
| Eptifibatide (Integrillin) | yes | 2 to 4 hours |
| Ticagrelor (Brillinta) | yes | 3 days |
If you are given antibiotics, please take these one hour before your procedure. If you have not been given antibiotics, please arrive for your appointment one hour early so that a nurse can give them to you.
You must not drive for 24 hours after your procedure. Please arrange for someone to take you home from hospital.
What will happen when I arrive at the hospital?
Please go to the reception desk in the Outpatients or Urology Department. Your appointment letter will list the details.
You will be seen by the specialist who will explain your procedure, before asking you to sign a consent form. Please use this time to ask any questions and raise any concerns you may have.
Why do I need to sign a consent form?
All patients must give permission before they receive any type of medical treatment, test, or examination. Consent is usually given when you sign the consent form before your treatment, but we may ask you to give it verbally.
You must give your consent voluntarily.
The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent. If you have not been given this information, or you have but you still have questions, please speak to a member of staff.
You must be capable of giving consent. This means that you understand the information given to you and can make an informed decision.
When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.
What will happen during my biopsy?
You will be asked to lie on your left-hand side on a couch, with your knees drawn up.
A ultrasound probe is gently inserted into your rectum. This will give your doctor an image of your prostate gland, for an accurate placement of the biopsy. A local anaesthetic is given through the probe to remove some of the feeling.
While scanning your prostate gland, the doctor will take 12 or more biopsies from your gland. These biopsies are small samples of your gland. The biopsies are taken with a spring-loaded biopsy needle. The procedure is not normally painful. You will hear a loud click when each biopsy is taken. Some patients have described this as uncomfortable.
How long will it take?
The complete consultation takes about 30 minutes, but the biopsy takes about 15 minutes.
After your biopsy, you will be asked to stay in the department for about 30 minutes, or until you have passed urine.
How will I feel after the procedure?
You may have mild discomfort in the biopsy area. The discomfort may last for 1 or 2 days after your biopsy.
You may notice some blood in your urine for up to 10 days. Drink plenty of non-alcoholic drinks while you have blood in your urine.
Your semen may be discoloured (pink or brown) for up to 6 weeks, and occasionally longer. This is nothing to worry about.
Do not drive for 24 hours after your procedure, or until pain allows and you can carry out an emergency stop pain free. Please arrange for someone to take you home from hospital after your procedure.
What do I need to know before I go home?
Before you leave hospital, we will tell you how your procedure went. Please make sure:
You understand what has been done.
Ask your surgeon if everything went as planned.
Let staff know if you have any discomfort.
Ask what you can and cannot do at home.
You know what happens next.
Ask when you can return to your normal activities. Normal activities include work, sport, housework, gardening, and driving.
Will I have a follow-up appointment?
Yes. A pathologist will examine the biopsies we have taken. You will have a follow-up appointment within 2 weeks of your procedure. At this appointment you will discuss your results with your urologist or cancer nurse specialist.
Can I drive after my procedure?
Do not drive for 24 hours after your procedure, or until your pain allows and you can do an emergency stop without any pain.
Please arrange for someone to take you home from hospital after your procedure.
Are there any risks or complications?
You may have small amounts of blood from your rectum and in your urine for 24 to 48 hours after your procedure (sometimes longer); this is normal. If it becomes heavy or continues for more than 48 hours, see your GP.
Rarely, heavy bleeding happens during a biopsy. If this does happen, you will stay in the department until it settles.
Infection is unusual, but it is the most common complication. It usually occurs 24 to 48 hours after your procedure. To help prevent infection, you will be given antibiotics to take at home. You may need hospital treatment with intravenous (IV) antibiotics if the infection is severe.
Despite these risks, your doctor will have decided that you should have this examination. Remember that the risks from missing a serious disorder by not having the procedure are considered to be much greater.
What if I have any questions or concerns?
Please go to the Urgent Treatment Centre at Kent and Canterbury Hospital or your local Emergency Department if you experience any of the following.
Your pain gets worse.
You have a temperature higher than 100.4°F (38°C).
You do not pass urine for 8 hours.
You start to pass large clots of blood.
You have heavy and non-stop bleeding.
If you visit the Emergency Department, please ask them to contact the on-call urology doctor at Kent and Canterbury for advice. The number is 0207 188 7188, bleep number 1228.
If you have any questions about this procedure or your results, please contact:
Prostate Cancer Nurse Specialists
Telephone: 01227 868666 (Monday to Friday, 9am to 5pm)Urology Department
Telephone: 01227 864383 (out of hours)
Further information
[Web site last accessed 12 May 2026]
References
[Web site last accessed 12 May 2026]
This leaflet is produced with grateful acknowledgment to the Patient’s Liaison Group of the Royal College of Radiologists and East Kent Radiology Staff.
Ask 3 Questions
There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:
What are my choices?
What is good and bad about each choice?
How do I get support to help me make a decision that is right for me?
Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.
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We have used the terms 'male' and ‘men’ in this leaflet. When we use these terms we also mean people with male reproductive organs who do not identify as a man. East Kent Hospitals is committed to supporting people of all gender identities. Please tell your doctor how you would like them to address you, so we can be sure to get this right.