Quick answer: A prostate biopsy takes small samples of prostate tissue so they can be examined under a microscope to check for cancer. In Singapore it is usually arranged by a urologist after a raised PSA blood test, an abnormal examination, or a suspicious area on an MRI scan. The samples can be taken through the back passage (transrectal) or through the skin behind the scrotum (transperineal), often guided by ultrasound. Antibiotics are given to reduce infection risk. Afterwards, some blood in the urine, semen or from the back passage is normal for a while. Seek urgent care if you develop fever or chills, cannot pass urine, or feel very unwell.
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Being told you need a prostate biopsy can feel worrying, but it is a common and well-established test. Knowing what it involves, why it is recommended and what to expect afterwards can make the experience far less daunting. This guide explains the procedure in plain terms for men in Singapore.
What it is
A prostate biopsy is a procedure to take small samples of tissue from the prostate gland, which sits just below the bladder. These samples are sent to a laboratory and examined under a microscope by a specialist doctor to check for prostate cancer and, if cancer is present, to understand how it might behave. A biopsy is the only way to confirm a diagnosis, because blood tests, examinations and scans can raise suspicion but cannot give a definite answer on their own.
Why it’s done
A urologist usually recommends a biopsy when there are signs that the prostate needs closer examination. This is often after a raised PSA (a protein measured in a blood test), an abnormal finding when the doctor examines the prostate, or a suspicious area seen on an MRI scan. Increasingly, an MRI scan is done first so that any concerning areas can be identified and the biopsy can be aimed, or “targeted”, at them. This helps the specialist take samples from the most relevant parts of the gland rather than sampling blindly.
Types and approaches in plain terms
There are two main routes. In a transrectal biopsy, the samples are taken through the wall of the back passage. In a transperineal biopsy, they are taken through the skin of the perineum, the area behind the scrotum. Both are commonly performed in Singapore hospitals such as SGH and NUH, and the choice depends on your circumstances and your urologist’s judgement. The procedure is usually guided by an ultrasound probe, and the pictures from an earlier MRI may be combined with the live ultrasound so the specialist can target suspicious areas accurately.
How to prepare
Your care team will give you specific instructions, and it is important to follow them. You will usually be given antibiotics around the time of the procedure to reduce the risk of infection. If you take medicines that affect bleeding, such as blood thinners, you may be advised to pause them beforehand, but never stop any medication on your own without checking with your doctor. You may be asked about allergies and other health conditions. Depending on the approach and the type of anaesthetic, you may need someone to accompany you home and should arrange time to rest afterwards.
What happens during the procedure
A prostate biopsy is done under local or general anaesthetic depending on the approach and your situation. You will usually lie on your side or on your back with your legs supported. An ultrasound probe is used to produce images of the prostate and guide the specialist. Using a fine needle, several small samples are taken quickly from different parts of the gland. Each sample takes only a moment. The procedure itself is generally short, and you are monitored before you go home the same day in most cases.
After the procedure
It is normal to notice some blood in the urine, in the semen, or from the back passage for a while after a biopsy. Semen may look pink, red or brownish for some time, which can be alarming but is expected and settles on its own. Mild discomfort or aching around the area is also common. Drinking plenty of fluids can help. Most men return to their usual activities within a day or two, following any advice from their care team.
Risks
A prostate biopsy is generally safe, but like any procedure it carries some risks, which your urologist will explain honestly. Infection is an important one, and this is why antibiotics are given to reduce the chance of it. Bleeding can occur, seen as blood in the urine, semen or from the back passage. Some men have temporary difficulty passing urine afterwards. Temporary blood in the semen is very common and not a cause for concern on its own. Serious problems are uncommon, but it is worth knowing the warning signs listed below.
Getting results and next steps
The samples take time to be processed and examined in the laboratory, so results are not available immediately. Your urologist will discuss them with you at a follow-up appointment. A result showing no cancer is reassuring, though your doctor may still recommend monitoring if suspicion remains. If cancer is found, the report gives information about how it looks under the microscope, which helps guide the next steps, such as further scans, active monitoring or treatment. Whatever the outcome, your specialist will explain what it means for you.
When to seek urgent help
Go to your nearest A&E or call 995 if, after a prostate biopsy, you develop a fever or chills, are unable to pass urine, have heavy bleeding or pass clots, or feel very unwell. These can be signs of a serious infection (sepsis) or of urinary retention, and both need prompt medical attention. When in doubt, seek help early rather than waiting.
Common questions
Is a prostate biopsy painful?
Most men find it uncomfortable rather than very painful. Local or general anaesthetic is used to keep you comfortable, and any soreness afterwards is usually mild and short-lived.
How long does the procedure take?
The biopsy itself is generally short, as each sample takes only a moment. You will also spend time being prepared beforehand and monitored afterwards, so allow for the whole visit rather than just the procedure.
Why might I have an MRI before the biopsy?
An MRI scan can highlight suspicious areas in the prostate. Doing it first lets your urologist target the biopsy at those areas, which can make the sampling more accurate.
Is blood in my semen normal afterwards?
Yes. Blood in the semen, giving it a pink, red or brownish colour, is very common after a biopsy and can last for a while. It usually settles on its own and is not a cause for concern by itself.
Does a biopsy affect erections or fertility?
A prostate biopsy is not intended to affect erections or fertility, and any temporary changes usually settle. If you have ongoing concerns, discuss them with your urologist.
Related guides
Sources
- Singapore General Hospital
- HealthHub
- British Association of Urological Surgeons
- NHS
Disclaimer: This guide is general information and not a substitute for personal medical advice. Please speak with a qualified urologist or your doctor about your own situation. In an emergency, go to your nearest A&E or call 995.