TRUS of the Prostate and Biopsy

Patient Leaflets Team

  • Reference Number: HEY-121/2017
  • Departments: Radiology
  • Last Updated: 5 July 2021


This leaflet has been produced to give you general information about your procedure.  Most of your questions should have been answered by this leaflet/booklet. It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the health care team who has been caring for you.

Why do I need a TRUS of the Prostate and Biopsy?

You have probably been troubled by some symptoms related to your bladder/prostate or you have had a blood test which has shown a raised PSA (Prostate Specific Antigen). Following discussion with your doctor, he has advised that you undergo a TRUS and biopsy of the prostate.

TRUS stands for Trans Rectal UltraSound

Biopsy involves taking sample of tissue, in this case several tissue samples of the prostate. This sample is analyzed under a microscope to help your doctor diagnose the cause of your symptoms.

This test is often performed to confirm or exclude a diagnosis of prostate cancer. Attending to have this test performed does not mean you have cancer, but your doctor may want to exclude this possibility.

How do I prepare for a TRUS and Biopsy?

Please read the information leaflet.  Share the information it contains with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this examination.




  • A regular prescription for a blood thinning agent (for example warfarin, aspirin, clopidogrel, rivaroxaban or dabigatran);
  • A latex allergy
  • A known allergy/resistance to any of the following antibiotics; gentamicin, metronizadole, ciprofloxacin.

What should I expect to happen?

Report to the Radiology (X-Ray) department reception, entrance 2 Castle Hill Hospital. You will be directed to the Ultrasound Department where you will be asked to take a seat until a member of the team calls you to discuss the procedure with you.

You will not be called immediately for your procedure and you may have a wait before your procedure commences. All gentlemen undergoing this procedure are asked to arrive for their appointment at the same time. This is to ensure that if we encounter any problems, we have time to rectify them before your procedure starts.

You could be in the ultrasound department for up to 3 ½ hours as there is some preparation and recovery time required before and after your procedure.

Before the procedure, a radiology nurse will place an intravenous cannula into your arm to administer liquid antibiotics. You will also be given oral antibiotics.

Your procedure will be performed by a sonographer. The sonographer will explain the procedure to you and answer any relevant questions you may have. You will then be asked to give written consent. You will be taken to a changing room to change into a hospital gown. Your trousers and underwear and will need to be removed.

During the procedure you will be asked to lie on your left side and the sonographer will put a small specially designed ultrasound probe into your back passage; this will allow the sonographer to see your prostate image in real time on the ultrasound machine monitor.

A local anaesthetic (usually Lidocaine 1%) will be injected at the left and right side of the prostate to make the exam more comfortable.

The sonographer will then advance the biopsy needle through a probe guide, under ultrasound guidance, into the prostate to take a sample. This will be repeated a number of times in both sides of the prostate. A minimum of 10 samples will be taken. You will be able to hear the biopsies being taken.

You may feel some discomfort during the procedure and you can let someone know. You will be accompanied by a health care worker throughout.

What happens afterwards?

Once the procedure has been completed you can get dressed and you will be asked to sit and wait in our waiting room. You will be given a drink and a biscuit and asked to remain in the department until you have passed urine. This procedure can sometimes cause swelling of the prostate and we prefer that you stay in the department until we are sure you can pass urine normally.  It is not uncommon for there to be some blood present in the urine following this procedure and your sample will be checked to make sure that if there has been any bleeding it is not excessive. Once your sample has been checked and found to be satisfactory, your cannula will be removed and you will be allowed home.

The biopsy results will be sent to your referring Urologist. This will take three weeks. The urologist will contact you to disclose and discuss your results.




Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Ultrasound Department on telephone number: ( 01482) 624044.

What are the possible complications?

Post procedure complications can include some rectal bleeding, blood in the urine (haematuria), urinary retention and infection.

You must let the healthcare team looking after you if you feel any symptoms of an infection after the procedure.

There is a small risk of developing a serious infection. This would normally happen within 5 days following the procedure. If, once you have left the hospital, you develop a fever, feel hot and sweaty or experience pain in the lower back passage you should immediately contact WARD 15, CASTLE HILL HOSPITAL on telephone number (01482) 623015 and speak to the SENIOR UROLOGY HOUSE OFFICER ON CALL. He/she will deal with the problem. In the majority of cases none of these problems arise.

Post-operative pain management – After the procedure you should not feel unwell but any discomfort can be relieved by taking the recommended dose of paracetamol or co-codamol tablets.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.