As with other medical tests, prostate biopsy carries potential risks, and there are contraindications for which the test should not be performed. What are the potential risks of prostate biopsy? Some of the risks of a prostate gland biopsy may be more important in certain men than in others, so it should not be forgotten to discuss them with the doctor: Difficulty passing urine. Some men may have difficulty or inability to urinate after the procedure and may need a catheter until the swelling goes down (usually two to three days); Rectal bleeding. Sometimes rectal bleeding can be excessive and require surgical treatment; Infection. Local or generalized infections (sepsis) can occur and are responsible for about 75% of hospitalizations in the 30 days after prostate biopsy, making infection the most common cause of complications for hospital admission. Infections appear to be less common with MRI/targeted biopsies (as fewer samples are taken with this type of biopsy), but infections associated with prostate biopsies are currently on the rise. With MRI/targeted biopsies, there is a rare risk of nephrogenic systemic fibrosis (NSF) – a rare, sometimes fatal disease that affects the skin and organs – due to the contrast material (gadolinium) used, but the risk is mainly in men with very poor kidney function The potential risks of prostate biopsy should be weighed against the potential benefits of the procedure. What are the contraindications for prostate biopsy? A relative contraindication for a prostate biopsy is the intake of blood thinners, which cannot be stopped for the procedure. When a biopsy is required, the risk of bleeding during the procedure must be weighed against the risk of stopping the blood thinner. You should never stop taking a prescribed medication without consulting your doctor. A biopsy of the prostate gland should not be performed in men who have a rectal fistula (an abnormal channel connecting the rectum to the skin) or in men who have had rectal surgery. References: 1. Tikkinen KAO, Dahm P, Lytvyn L, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline 2. Naji L, Randhawa H, Sohani Z, et al. Digital Rectal Examination for Prostate Cancer Screening in Primary Care: A Systematic Review and Meta-Analysis 3. Guo G, Xu Y, Zhang X. TRUS-guided transperineal prostate 12+X core biopsy with template for the diagnosis of prostate cancer 4. Applewhite JC, Matlaga BR, McCullough DL, Hall MC. Transrectal ultrasound and biopsy in the early diagnosis of prostate cancer