Trans-rectal ultrasound scan (TRUS) biopsy
You will usually be offered a type of biopsy called a trans-rectal ultrasound scan (TRUS) biopsy. You lie on your left side with your knees pulled up to your chest. A small ultrasound probe is passed gently into the rectum using lubricating gel. This will show an image of the prostate on a screen. This helps the doctor guide a needle into the prostate. The needle takes a sample of tissue (a biopsy). The doctor will usually take 12 small samples of tissue from the prostate. A pathologist (a doctor who specialises in studying cells) looks at the tissue under a microscope to check for cancer cells.
Some men find having a TRUS biopsy uncomfortable. You will have a local anaesthetic to numb the area and reduce any pain or discomfort. The doctor will also give you antibiotics to reduce the risk of infection.
For 24 hours after this test, it is important to drink plenty of fluids. You may have blood in your semen for up to a few weeks after the scan. You may also have a small amount of blood in your pee or poo (stools). If these symptoms do not go away, speak to your doctor.
If you are a man who receives anal sex, you should avoid this for a few weeks until the biopsy area has healed. Talk to your doctor or specialist nurse if you need more advice.
In some situations, doctors may think there is cancer in the prostate even if it hasn’t been found by a biopsy. This may be because of the level of PSA. If this happens, you may be offered a specialised type of MRI scan to decide whether another biopsy is needed.