An accurate, targeted biopsy technique that combines MRI imaging with real-time ultrasound to precisely sample areas of concern in the prostate — improving the detection of clinically significant prostate cancer.
A prostate biopsy involves taking small tissue samples from the prostate gland so that they can be examined under a microscope. MRI fusion biopsy is commonly performed — it uses your pre-procedure MRI scan as a map, overlaying it onto a live ultrasound image to precisely guide the biopsy needle to any areas of concern that were identified on your scan.
The transperineal approach is used for MRI fusion biopsy. This means the biopsy needles are passed through the skin between your scrotum and back passage (the perineum), rather than through the rectum. This route reduces the risk of infection and allows thorough sampling of the entire prostate. Multiple small tissue samples — typically 12 to 24 — are taken from targeted and systematic areas. A transrectal (TRUS) biopsy under local anaesthetic is also available and can be discussed at your consultation.
Results are available within a week.
02
Before your procedure
Your MRI scan must be completed before the biopsy is booked. Dr Tan will review the images with you at your consultation.
You should fast for six hours beforehand. You may drink water up to two hours prior.
If you take blood-thinning medication (warfarin, aspirin, clopidogrel, rivaroxaban, apixaban), inform Dr Tan in advance. These may need to be paused before the procedure.
Take all other regular medications as usual unless advised otherwise.
No preventive antibiotic is required.
Arrange for someone to drive you home after the procedure.
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Risks and benefits
Targeted accuracy
MRI targeted biopsy improves the detection of cancers which may be missed by standard biopsy.
Lower infection risk
The transperineal approach avoids the bowel entirely, making serious infection very rare.
Confidence in results
A negative result on MRI fusion biopsy provides greater reassurance than older methods.
Common
Blood in urine or semen
Temporary blood-staining of urine, semen, or the bowel can occur and usually resolves within a few weeks. This is normal and not a cause for alarm.
Common
Discomfort at the biopsy site
Some tenderness around the perineum is expected for a few days. Simple over-the-counter pain relief is usually sufficient.
Uncommon
Urinary tract infection
Infection risk is very low with the transperineal route, and no preventive antibiotics are required. Contact the team if you develop fever or worsening symptoms.
Uncommon
Difficulty passing urine
Temporary urinary retention can occur, particularly in men with a large prostate. This usually resolves within 24–48 hours.
Rare
Significant bleeding or haematoma
Rarely, a collection of blood (haematoma) may form in the perineum. This usually settles without intervention.
Rare
Cancer may not be detected
No biopsy technique is 100% sensitive. A small number of cancers may not be sampled. If strong clinical suspicion persists, a repeat biopsy may be recommended.
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Aftercare and recovery
1
Hydration
Drink plenty of fluids — around 2 litres of water per day — for the first 3–4 days. This helps flush the urinary tract and reduces discomfort.
2
Rest
Most patients go home the same day and feel well enough to return to light activities within 24–48 hours. Avoid strenuous exercise or heavy lifting and cycling for one week.
3
Blood in urine / semen
This is expected and can last several weeks, particularly in semen. It does not require treatment. If you experience heavy or persistent bleeding, contact the clinic.
4
Results and follow-up
Your tissue samples will be reviewed by pathology and results are typically available within a week. Dr Tan will personally discuss your results with you at a follow-up appointment.
When to seek urgent advice
Contact the clinic promptly if you develop: a temperature above 38°C, severe difficulty passing urine, heavy bleeding, or significant worsening pain. Out of hours, please attend your nearest emergency department.
What did my MRI scan show that prompted this biopsy?
How many samples will be taken, and from where?
What happens if the biopsy is positive for cancer?
What happens if the biopsy is negative?
What are the chances of needing a repeat biopsy?
How long will I need off work?
Can I continue my blood-thinning medication?
Disclaimer
This information is for general education and is not a substitute for personal medical advice.
Content adapted from the British Association of Urological Surgeons (BAUS) and the American Urological Association (AUA) patient information resources.