Trans-perineal biopsy
Doctors use a TP biopsy test to diagnose prostate cancer. They take samples of tissue from the prostate gland to look for cancer cells.
What is a trans-perineal (TP) biopsy?
If a rectal examination and PSA tests show there is a possibility of prostate cancer, you may have a biopsy. Your doctor may talk to you about having a trans-perineal (TP) biopsy.
A TP biopsy is when they take samples of the prostate gland through the area between the scrotum and the back passage (called the perineum). A doctor called a pathologist looks at the samples under the microscope to check for cancer.
Your doctor or nurse will talk to you about the benefits and disadvantages of having a TP biopsy. They will explain the possible risks, such as infection.
A TP biopsy can be done under a general anaesthetic. Or, it can also be done using a local anaesthetic to numb the area first. You may need to take an antibiotic before the biopsy to help prevent infection.
Having a TP biopsy
You lie on your back and the nurses place your legs in special supports (stirrups) to help the doctor reach the prostate. The doctor passes a small ultrasound probe into the rectum using lubricating gel. This shows an image of the prostate gland on a screen. The images from your MRI scan may also be used.
The doctor passes a needle through the skin of the perineum. It can take many small tissue samples from different areas of the prostate gland using a grid (template biopsy). The doctor may take samples from a specific area of the prostate gland (targeted) or from the whole prostate gland.
What to expect after a TP biopsy
After the biopsy, a dressing is placed over your perineum. If you had a general anaesthetic, you may stay in hospital overnight.
Going home after a TP biopsy
When you go home, it is important to follow the advice your doctor or nurse gave you.
For 24 hours after the test, it is important to drink plenty of fluids. Make sure you take any antibiotics you have been given.
You may have a small amount of blood in your pee for up to 2 weeks. There may also be blood in your semen for up to a few weeks. If these symptoms do not go away, speak to your doctor.
Drink plenty of fluids like water to help reduce the risk of a urine infection. See your GP if you have pain peeing or your pee is cloudy or smelly.
Contact a doctor straight away if you:
- have a lot of bleeding
- feel shivery with a temperature over 37.5°C (99.5°F)
- have problems peeing even though you are drinking lots.
About our information
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References
Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
C. Parker, E. Castro, K. Fizazi, et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2020, Volume 31, Issue 9, p1119-1134. Available from www.esmo.org/guidelines/genitourinary-cancers/prostate-cancer
National Institute for Health and Care Excellence (2019) Prostate cancer: diagnosis and management (NICE guideline NG131). Last updated December 2021 to include Risk stratification for localised or locally advanced prostate cancer. Available at www.nice.org.uk/guidance/ng131
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Jim Barber, Consultant Clinical Oncologist and Dr Ursula McGovern, Consultant Medical Oncologist.
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