Transperineal Ultrasound-Guided Prostate Biopsy

What is a Transperineal Ultrasound-Guided Prostate Biopsy?

A prostate biopsy is recommended as further investigation of an elevated PSA or an
abnormality of the prostate on rectal examination. The procedure is performed under ultrasound guidance with a transperineal approach.

Ultrasound uses sound waves to produce images. It is completely safe and there is no radiation. The ultrasound probe (transducer) is placed into your rectum and biopsies are then taken from your prostate through the perineum (the skin between your scrotum and rectum).

The procedure is normally carried out under a general anaesthetic (where you are put to sleep) or a spinal anaesthetic (where you are awake but unable to feel anything below the waist). You are positioned in special supports which helps to access the skin behind your scrotum. The biopsy needle is guided by use of the ultrasound and depending on the size of your prostate, a special template is used to obtain between 20-40 core samples.

Preparing for your procedure

We will provide you with instructions regarding all aspects of preparing for your operation:

  • Pre-operative urine test (blood test if required)
  • Details of admission to hospital
  • Information regarding fasting and medications
  • Holding of any blood-thinning medications

**Please read our admission letter carefully regarding any medical instructions.**

What to expect afterwards

It is usual to experience some bleeding from the urethra after the biopsy. This can last from 2 days to 2 weeks, but it usually settles within 1 week. You may also see blood in the semen which may last for several weeks, depending on how often you ejaculate. This is not dangerous. Approximately 25% of men will have some discomfort passing urine afterwards but this usually settles quickly.


Urinary Retention

Having biopsies may cause internal bruising and swelling. There is a possibility (5%) that you may not be able to pass urine after this procedure. You will be closely monitored post operatively. Urinary retention is more likely to occur in men who had difficulties passing urine before their biopsy. If this happens you would most likely need a catheter for a short time.


There is a small risk (1%) of developing an infection in the blood stream – septicaemia. This can cause you to feel unwell with fevers and chills. If this happens contact us immediately. You may need admission to hospital for treatment with antibiotics through a drip. In the unlikely event this happens overnight you will need to go to a hospital emergency department.


You should expect to see some blood in the urine mentioned above. If the urine is red then you should drink extra fluid to help keep the urine lighter in colour. If the bleeding seems excessive, or you are passing clots in the urine, then you should contact us. You may need to be admitted to hospital.

Other complications can include; perineal bruising (10%), discomfort in the prostate (10%), and temporary erectile problems (5%).

Urinary Tract Infection

If you have burning when you pass your urine that does not seem to be getting better after 2 days then you could have a urine infection. Please contact us to organise a urine test and assessment.

Other complications can include; perineal bruising (10%), discomfort in the prostate (10%), and temporary erectile problems (5%).

After discharge from hospital

We suggest that you rest quietly for the remainder of the day. Please avoid heavy lifting or straining until the blood clears from the urine.


You should not drive for at least 24 hours after having a general/spinal anaesthetic (or as instructed by your Urologist).

Patients who are travelling outside the metropolitan area are required to check when they are able to travel, and will be required to stay in the metropolitan area for 24 hours (or as instructed by your Urologist).

Emergency Contacts

In the event of an emergency, call our office within business hours and speak to our Practice Nurse. If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.

Ashford Hospital
55 Anzac Highway, Ashford SA 5035
8375 5205
Until 10:00 PM

Flinders Medical Centre (access to Flinders Private Hospital)
Flinders Drive, Bedford Park SA 5042
8204 5511
24 Hours

Calvary Adelaide Hospital
120 Angus Street, Adelaide SA 5000
8227 7027
24 Hours Royal

Royal Darwin Hospital
Rocklands Drive, Tiwi NT 0810
8922 8888
24 Hours

**For patients outside the Metropolitan area, please present to your nearest hospital emergency department.

Follow Up

A post operative appointment will be planned at the time of booking your procedure.

If you have any concerns after your procedure, then please contact us at Urological Solutions.