Prostate Biopsy & Fiducial Seed Placement

Your prostate is a walnut shaped gland that is located below your bladder and sits directly in front of your rectum. It surrounds your urethra, which drains urine from your bladder.

Prostate Biopsy

A prostate biopsy is done to collect small pieces of tissue from the prostate for examination under a microscope to check for prostate cancer and other disorders. The procedure is typically done at our office with patients awake but under local anesthetic and is tolerated by most patients. In rare cases the biopsy is done in the operating room.

The biopsy is done by first gently placing a probe into the rectum (up the bottom). The ultrasound allows the doctor to see a picture of the prostate, measure it and and target the biopsy needle. The biopsies are done through the ultrasound probe. Before the biopsies start, you will also get an injection to numb the prostate. It will be similar to what you get at a dentist’s office. A thin biopsy needle will be used to take each sample. Your doctor may 12 to16 biopsy samples. The procedure takes 10-15 minutes. We will know the result of the biopsy in approximately one week.

Prostate Fiducial Seed Placement

In patients who are planning to undergo radiation therapy for prostate cancer, a small gold marker (fiducial marker) is placed into the prostate tissue with the same method as a biopsy. The markers help the radiation doctors target the prostate better. The marker placement is a much shorter procedure than a biopsy as we only place 3-4 markers during the procedure.

Before Your Procedure

Tell the doctor if you:

  • Take medication to thin your blood (anticoagulants), such as: Aspirin, Clopidogrel, Plavix, Dalteparin, Fragmin, Rivaroxaban, Xarelto, Heparin, Lovenox, Warfarin, Coumadin, Prasugrel, Effient
  • Take steroids such as prednisone or arthritis medications
  • Take any other medications, such as herbs, vitamins, minerals, or natural or home remedies.
  • Have taken any antibiotics in the past 3 months.
  • Have any sort of heart condition, implanted devices such as knee or hip replacements.
  • Are allergic to any medications or latex.
  • Had a urinary tract infection in the last month or an infection after a previous prostate biopsy.
  • Have a history of Achilles tendon injuries or tendonitis.
  • Have difficulty hearing.
  • Work at a hospital or nursing home.

5 to 7 days Before Your Procedure

Stop taking:

  • Aspirin and medications that contain aspirin, unless directed otherwise by the doctor
  • Vitamin E, Multivitamins
  • Stop taking other stronger blood thinners (like plavix, xarelto or warfarin) as directed by your primary doctor or cardiologist

2 Days Before Your Procedure

Stop taking pain medicines like:

  • Ibuprofen (Advil® or Motrin®) or Naproxen (Aleve®)

1 Day Before Your Procedure

  • Start taking antibiotic pills that will be given to you by our office staff to be taken twice per day (one in the morning one at night).
  • You will continue the antibiotics on the day of the procedure and one day after the biopsy.
  • The evening before the procedure, please take 2 tablespoons of Milk of Magnesia (purchased at any pharmacy) followed by 3 to 4 glasses

The Day of Your Procedure

  • Must have a good breakfast/lunch (if the procedure is done at the office)
  • If the procedure is done in the operating room at a hospital, then you may not eat or drink anything for 8 hours prior to the procedure
  • Take ALL your blood pressure and heart medications as usual
  • Continue taking antibiotic pills
  • 2 hours before procedure, you need to do one Fleet Enema to have a good bowel movement
  • If you have taken any medications for anxiety or will have the procedure at the hospital asleep, then you will need to have someone drive you home. You will not be allowed to take a taxi.

LOCATION

Broward Urology Center
1200 E. Broward Blvd
Fort Lauderdale, FL 33301
Ok to eat prior to procedure

Broward Health Medical Center
1600 South Andrews Ave
Fort Lauderdale, FL 33316
Do not eat/drink 8 hrs prior

After the Biopsy

After the biopsy, you may experience some slight discomfort in the rectal area, and you may see some blood in the urine, blood in the stool with bowel movements, or some blood staining in the underwear for a few days. A few drops of blood may drip from the tip of the penis for a day or two as well. This is normal. It is quite common to see bloody discoloration of the semen with ejaculation for up to 6 weeks after your biopsy, due to the presence of small amounts of blood. This is completely normal, and will not harm you or your partner. You may also note some temporary burning on urination, or the need to urinate more frequently. If these symptoms do not resolve in a few days, or if you develop heavy bleeding or pass large blood clots from the rectum or in the urine, please contact our office.

Please refrain from strenuous physical activity for at least 24 hours after your biopsy. This means no sports, jogging, weight-training or sexual activity.

We have prescribed several doses of antibiotics to be taken after your biopsy to prevent an infection. If you notice any signs of infection such as temperature over 101 F, or the onset of chills, vomiting, severe fatigue, dizziness or confusion please go to the nearest emergency room for an evaluation and contact our office regarding your condition.

For a printable handout to refer to please click here.

Locations