Discharge Instructions and Patient Counseling After Prostate Biopsy
After a prostate biopsy, patients should be monitored for 3 hours before discharge, and should be provided with clear written and verbal instructions about expected symptoms, potential complications, activity restrictions, and when to seek medical attention. 1
Immediate Post-Procedure Monitoring
- Monitor vital signs (pulse rate and blood pressure) every 15-30 minutes for the first hour, then hourly until discharge
- Ensure patient is hemodynamically stable with no evidence of bleeding
- Verify patient has no new complaints of pain or shortness of breath before discharge
Expected Post-Procedure Symptoms
- Blood in urine: Common for days to weeks after procedure
- Blood in semen: May persist for several weeks (up to 4-6 weeks)
- Blood in stool: May occur for a few days
- Soreness/discomfort: In the rectal and prostate area for 1-2 days
Activity Restrictions
- Rest for the remainder of the day of the procedure
- Do not drive any motor vehicles or operate heavy machinery on the day of the biopsy
- Avoid strenuous physical activities for 48 hours after the biopsy, including:
- Running
- Contact sports
- Heavy lifting
- Vigorous exercise
- Sexual activity: Avoid for 1 week or as advised by your physician (blood in semen may be alarming but is expected)
Medication Instructions
- Continue antibiotics as prescribed to prevent infection
- You may take acetaminophen (Tylenol) for discomfort
- Resume blood thinners only when instructed by your physician
- If you were on blood thinners before the procedure, ask specifically when to restart them
When to Seek Immediate Medical Attention
Contact the hospital or emergency services immediately if you experience:
- Fever over 101°F (38.3°C) or chills
- Difficulty urinating or inability to urinate
- Excessive bright red bleeding from the rectum
- Severe pain in the abdomen, pelvis, or chest
- Increasing abdominal swelling
- Dizziness, lightheadedness, or fainting
- Worsening symptoms after 3-4 days
Follow-up Instructions
- Schedule a follow-up appointment to discuss biopsy results (typically within 1-2 weeks)
- Continue taking prescribed medications as directed
- Call the provided contact number if you have any questions or concerns
Special Considerations
Infection Prevention
Infectious complications, while uncommon (2.2-2.7%), can be serious 2, 3. Patients should:
- Complete the full course of prescribed antibiotics
- Monitor for signs of infection (fever, chills, cloudy urine)
- Seek immediate medical attention if infection is suspected
Bleeding Management
Hematuria (39-53%) and rectal bleeding (12-26%) are common complications 4:
- Increase fluid intake to help clear blood from urine
- Use mild stool softeners if constipated to reduce straining
- Avoid blood thinners unless specifically instructed otherwise
Contact Information
Before discharge, ensure the patient has:
- A written copy of these instructions
- Contact information for emergency assistance
- Date and time of follow-up appointment
- Information about when and how biopsy results will be communicated
The risk of serious complications requiring hospitalization is low, but early recognition and treatment of infection are critical to prevent sepsis, which can occur within 48 hours after the procedure 5.