Prostate Biopsy: The Questions Patients Actually Ask — Answered by Physicians
Prostate Biopsy generates some of the most repetitive phone calls in any urology practice: antibiotic timing, blood-in-semen worries, and how results arrive. PrepQ, a patient-education platform built by physicians and operated by PrepQ LLC, maintains 50 physician-written answers about prostate biopsy as part of a library of more than 7,500 answers covering 700-plus procedures across 14 specialties. Practices that subscribe to PrepQ give their patients a dedicated phone number to text or call at any hour, and the platform replies instantly with content the practice's own clinicians have reviewed and approved in advance. Questions outside the approved library are referred back to the office, and any message that suggests urgent symptoms is directed to 911 or the practice instead of being answered by software. The result: patients arrive prepared, day-of cancellations drop, and staff stop repeating the same prostate biopsy instructions dozens of times a week.
Real prostate biopsy questions from our physician-reviewed library
A sample of the 50 prostate biopsy answers in PrepQ's library. Before any practice goes live, its own clinicians review and approve every answer — and can customize each one to their protocols.
After the biopsy it felt like someone kicked me in the groin for a couple of days — is that to be expected?
Feeling sore or bruised in the groin and perineum for a couple of days after a biopsy, like you were kicked, is common as the area heals, and it usually eases with rest and time. Mild pain relievers and avoiding strenuous activity help. However, if the pain becomes severe, you develop fever or chills, you cannot urinate, or you have heavy bleeding, contact your doctor right away, as those need prompt attention.
Can a prostate biopsy cause erectile dysfunction, and will it come back?
A prostate biopsy can cause temporary erectile changes in some men, often from soreness, anxiety, or short-term swelling, and these usually improve within weeks to a few months. Lasting erectile dysfunction directly from a standard biopsy is uncommon. If your erections do not return to normal after a couple of months, let your urologist know, since there are treatments that can help. Other health factors can also play a role.
Can I request to be fully knocked out (general anesthesia) for my biopsy, or do most just do local?
Most prostate biopsies are done with local anesthesia in the office, which many men tolerate well, but you can ask about sedation or general anesthesia, especially if you have high anxiety, a low pain tolerance, or a complex situation. Availability depends on the center, and being fully asleep usually means a hospital or surgery setting and a ride home. Talk with your urologist about which option is realistic and best for you.
Do I have to stop my low-dose aspirin before the biopsy, or is it safe to keep taking?
In many cases low-dose aspirin can be safely continued through a prostate biopsy, since the bleeding risk is usually small, but practices vary and the final call depends on why you take it. Do not stop it on your own. Ask your urologist whether to keep taking your aspirin or hold it, and follow the exact instructions they give based on your heart and stroke risk.
Do I really need the enema before a transrectal biopsy, and when do I do it?
For a transrectal biopsy, an enema is often used to empty the lower rectum, which can improve ultrasound imaging and may help lower infection risk. It is usually done a few hours before the procedure, often the same morning, following the specific instructions your office gives. If you are having a transperineal biopsy, an enema may not be needed. Follow your urologist's exact prep instructions, and ask if anything is unclear.
Does a longer wait for results mean bad news?
No, a longer wait usually does not mean bad news. Delays are most often due to lab workload, the number of samples, holidays, scheduling, or extra testing being added, not the findings themselves. It is easy for the waiting to fuel worry, but the timing rarely reflects the result. If the wait is longer than your office told you to expect, simply call and ask for an update; that is a reasonable thing to do.
Does being anxious make the biopsy hurt more, and is there anything I can take to calm down beforehand?
Yes, anxiety and muscle tension can make a biopsy feel more uncomfortable, so calming techniques really can help. Many offices can offer a mild medicine to help you relax beforehand, or deeper sedation in some settings, and numbing medicine is used during the procedure. Slow breathing and not tensing also help. Ask your urologist what relaxation or medication options they offer, and arrange a ride if you take anything sedating.
Does staying relaxed and not tensing actually help with the pain during the biopsy?
Yes, staying relaxed and not clenching really can reduce discomfort during a biopsy, because tense pelvic and rectal muscles make the probe and needles feel worse. Slow, steady breathing, letting your body go loose, and focusing on something calming all help. The numbing medicine does the main work, and your relaxation supports it. Ask your provider to talk you through each step so you can breathe and stay loose.
Even with the transperineal approach, do they still put an ultrasound probe in the rectum?
Yes, even with the transperineal approach, an ultrasound probe is usually placed in the rectum to create the live image that guides the needles, while the biopsy needles themselves go through the skin behind the scrotum rather than through the rectal wall. So the rectum is used only for imaging, which is part of why infection risk is lower. Ask your urologist to walk you through exactly how your biopsy is done.
How accurate is a 12-core biopsy — can it miss cancer that's actually there?
A standard 12-core biopsy is a good test but not perfect, and it can occasionally miss cancer, since it samples portions of the prostate rather than every area. That is why MRI targeting, your PSA trend, and sometimes a repeat biopsy are used to lower the chance of missing something. A negative result is reassuring but is interpreted alongside your other findings. Ask your urologist what your results mean in the context of your overall risk.
Your staff answers these 50 questions by phone. PrepQ answers them by text, instantly.
PrepQ gives your urology practice a dedicated number patients text or call 24/7. Physician-written answers, approved by your doctors, delivered in English and Spanish — with urgent messages escalated to your office or 911, never improvised. HIPAA-compliant, BAA provided, no EHR integration required.