Prostate biopsy.
When a PSA or exam raises concern, a biopsy is how prostate cancer is diagnosed and graded. Most are done quickly and comfortably in the office. Dr. Ursiny performs both transrectal and transperineal biopsies, each guided by your prostate MRI.
Why a biopsy — and what it tells us
A prostate biopsy takes small cores of tissue from the prostate to determine whether cancer is present and, if it is, how aggressive it is. That grade and extent drive every decision that follows — from active surveillance to surgery to radiation. Modern biopsies are not random; they are targeted using your MRI.
MRI-guided targeting
A prostate MRI obtained before the biopsy highlights the areas most likely to harbor clinically significant cancer. Dr. Ursiny uses that MRI to direct the needle into those specific targets — a fusion biopsy — while also sampling the rest of the gland systematically. Combining targeted and systematic sampling finds more significant cancers, and misses fewer, than older untargeted biopsies. This applies to both routes below.
Two approaches
There are two routes to the prostate. Dr. Ursiny performs both, and which one fits is decided together.
Transrectal — in the office (most patients)
For most men, the approach is a transrectal biopsy, in which the needle reaches the prostate through the wall of the rectum. It is done right in the office under local anesthesia, takes only a few minutes, and is well tolerated. With modern preparation and targeted antibiotics, the risk of infection is low. Because it does not require the surgery center, it is quick to schedule — and you are back to normal the next day.
Transperineal — at the surgery center
In a transperineal biopsy, the needle passes through the skin of the perineum (between the scrotum and the anus), avoiding the rectum entirely. Dr. Ursiny offers this approach as well; it is performed at the surgery center. It can be the right choice in specific situations — for example, a previous biopsy-related infection, certain anatomy, or hard-to-reach targets.
Which one is right for you?
For most men, an in-office transrectal biopsy is the fastest, most convenient route, with a low complication rate. The decision is made together — based on your MRI, your history, and your preferences.
What an in-office biopsy looks like
- Done in the office under local anesthesia
- A short visit; the biopsy itself takes only a few minutes
- You drive yourself home
- Most men return to normal activity the next day
- Results typically return within about a week
A transperineal biopsy at the surgery center is scheduled differently; the office will walk you through what to expect.
Who needs a biopsy
- An elevated or rising PSA
- An abnormal prostate MRI (a PI-RADS 3, 4, or 5 lesion)
- An abnormal digital rectal exam
- Follow-up during active surveillance
Not every elevated PSA needs a biopsy — sometimes an MRI or a repeat PSA changes the plan.
Risks worth knowing
- A small amount of blood in the urine, semen, or stool for a few weeks — common and harmless
- Mild soreness for a day or two
- Temporary difficulty urinating — uncommon
- Infection — low; for a transrectal biopsy, targeted antibiotics keep the risk down, and the transperineal route avoids the rectum altogether
What about the MRI?
If you have not had a prostate MRI yet, Dr. Ursiny will usually order one before recommending a biopsy. Sometimes the MRI changes the plan entirely.
Part of prostate cancer care at this practice — diagnosis, treatment, and long-term management.
Rising PSA? Bring your numbers.
New patients and second opinions welcome. Consultations are typically scheduled within two weeks.
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