When a doctor recommends a prostate biopsy, they are suggesting a procedure to collect small tissue samples from the prostate gland to analyze them for cancer cells. This diagnostic step requires specific preparation instructions from the patient. One common requirement is to abstain from all sexual activity that results in ejaculation. This instruction is based on physiological and biochemical reasons that directly impact the safety and accuracy of the biopsy.
How Ejaculation Affects Prostate Tissue
Ejaculation is a physical event that creates temporary changes within the prostate gland, situated just below the bladder. The process involves forceful contractions of the smooth muscles in the prostate and pelvic floor to propel seminal fluid.
The intense muscular activity can lead to temporary congestion and inflammation within the prostate tissue. This swelling is a localized, transient response. Introducing a biopsy needle into tissue that is already swollen can complicate the procedure for the urologist.
An inflamed prostate may make it difficult for the physician to accurately guide the biopsy needles to the target areas. This temporary irritation is associated with an increased likelihood of minor post-procedure complications. Patients who have recently ejaculated may have a higher frequency of complications like hematospermia (blood in the semen). This heightened risk of minor bleeding mandates abstinence to ensure the safest procedure.
Avoiding Fluctuation in Prostate Specific Antigen Levels
The second reason for abstinence relates to the biomarker Prostate-Specific Antigen (PSA). PSA is a protein produced by prostate cells, and its level in the blood is a primary factor in the decision to recommend a biopsy. Ejaculation causes a rapid, temporary spike in the concentration of PSA circulating in the blood. This increase occurs because forceful muscular contractions push a greater amount of PSA-rich prostatic fluid into the bloodstream.
This transient elevation is statistically significant, often peaking shortly after the event and remaining elevated for many hours. If a patient’s PSA level is measured close to the procedure date, an artificially elevated reading can complicate data interpretation. Doctors rely on a stable, baseline PSA measurement to monitor disease progression or compare against future readings. An inaccurate, elevated PSA level could create unnecessary concern or lead to unwarranted follow-up testing.
The Recommended Abstinence Timeline
To mitigate physiological tissue changes and biochemical blood fluctuations, medical professionals provide specific guidance on the timing of abstinence. For PSA stability alone, the National Comprehensive Cancer Network (NCCN) recommends abstaining from ejaculation for at least 48 hours before a blood test. This two-day window is generally sufficient for the PSA concentration to return to its stable baseline.
The period of abstinence recommended before the actual biopsy procedure is often longer to account for physical effects on the tissue. Many experts recommend abstinence lasting four days prior to the biopsy. Some data suggest that avoiding ejaculation for a full seven days may further reduce the risk of minor bleeding complications like hematospermia.
This instruction applies to any activity that results in the expulsion of semen, including sexual intercourse and masturbation. Patients should always follow the specific protocol provided by their urologist, as the exact timeline can depend on the physician’s preference and the type of biopsy being performed.