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Health condition

Prostate biopsy options

If a biopsy is needed, the transperineal approach - now standard in the UK - samples the prostate through the skin with a much lower infection risk than the older transrectal route.

Last reviewed 2026-09-27 · Next review due 2027-09-27

Key points

  • Transperineal biopsy (through the perineal skin) has largely replaced transrectal biopsy

  • Usually done under local anaesthetic with MRI-targeted plus systematic samples

  • Infection risk is dramatically lower than the transrectal route

  • Expect blood in urine and semen for days to weeks afterwards - this is normal

  • Results are discussed with a consultant urologist, typically within 1-2 weeks

Understanding it

About Prostate biopsy options.

A biopsy takes small cores of prostate tissue for analysis, guided by ultrasound and the MRI findings. The transperineal route avoids passing needles through the bowel wall, which is why infection and sepsis rates have fallen sharply since it became standard.

A local-anaesthetic transperineal procedure lasting 20-30 minutes, MRI-targeted sampling of any suspicious area, and a results consultation covering grade and next steps. On the NHS, routine referrals of this kind often take 20-45+ weeks in many areas, whereas a private consultant urologist can typically see you within around two weeks, with any tests and treatment arranged promptly afterwards.

A quiet reminder

This guide is for information, not medical advice.

Your GP or specialist knows your history and can tell you which parts apply to you. If in doubt, see them - and treat sudden severe symptoms as an emergency.

Frequently asked

Common questions about Prostate biopsy options.

Quick, plain-English answers to what people ask us most.

  • What is a prostate biopsy?

    A prostate biopsy is a procedure to take small tissue samples from the prostate gland, usually performed when other tests such as PSA levels or MRI raise concern about possible prostate cancer, to confirm or exclude a diagnosis.

  • What are the different types of prostate biopsy?

    The two main approaches are transrectal biopsy (via the rectum) and transperineal biopsy (through the skin between the scrotum and anus), each with slightly different risk profiles and, increasingly, MRI-targeted approaches to improve accuracy.

  • What is an MRI-targeted prostate biopsy?

    This approach uses prior MRI imaging to identify specific suspicious areas within the prostate, which are then specifically targeted during the biopsy, improving detection of significant cancers while potentially reducing unnecessary sampling of normal tissue.

  • Is a prostate biopsy painful?

    The procedure is usually performed under local anaesthetic, and while some discomfort is common, it's generally well tolerated, with most people experiencing only mild discomfort rather than significant pain.

  • What are the risks of a prostate biopsy?

    Risks include infection, bleeding (sometimes causing blood in urine or semen for a period afterwards), and, rarely, more significant complications; the transperineal approach may carry a lower infection risk compared with the transrectal route.

  • How long does it take to get prostate biopsy results?

    Results typically take around one to two weeks to become available, as the tissue samples need detailed laboratory analysis by a specialist pathologist.

  • How do I choose between transrectal and transperineal biopsy?

    Your urologist will discuss which approach is most suitable based on your individual situation, prior MRI findings, and local practice patterns, including relative risks and benefits of each specific technique.

  • Transrectal vs transperineal prostate biopsy — what's the difference?

    Transrectal biopsy passes the needle through the rectal wall, while transperineal biopsy passes through the perineal skin; the transperineal approach is increasingly favoured in some centres due to a potentially lower infection risk.

  • What happens after a prostate biopsy?

    Mild discomfort, some blood in urine or semen, and a small risk of infection are possible in the days following the procedure; you'll typically be advised on specific symptoms that would need prompt medical attention.

  • When should I see a specialist, and how quickly can I be seen privately?

    See a urologist to discuss biopsy options if recommended following raised PSA or MRI findings. Private urology assessment and biopsy scheduling is typically available within about two weeks, faster than standard NHS pathways.