KOELIS Surgical Navigation
Our image-guided navigation system aligns MRI and real-time ultrasound to steer the biopsy needle to the exact target. Think of it as GPS for the prostate — turning suspicious lesions into precisely sampled tissue.
Why Have Your Biopsy at Advanced Urology?
High-Resolution Micro-Ultrasound
We use micro-ultrasound imaging with ultra-fine resolution to visualize suspicious regions many systems miss — helping us see better, target better, and diagnose with confidence.
Transperineal First
Most biopsies are performed transperineally (through the skin between the scrotum and anus) to lower infection risk and improve access to anterior/apical lesions, with less discomfort for many patients.
How to Prepare
- Fleet® enema: Please complete a Fleet enema on the day of your procedure (or as instructed) to empty the rectal vault and optimize imaging and safety.
- Medications: Follow our team’s guidance regarding blood thinners and other meds.
- Fasting & arrival: We’ll provide simple anesthesia instructions and arrival times before your visit.
What to Expect on Procedure Day
Comfort in the ASC
Most biopsies are done in our Ambulatory Surgery Center with anesthesia — no pain during the procedure. Total time in the center is typically short, and you go home the same day.
- Procedure time: ~30 minutes
- Home the same day
- Minimal discomfort afterward, managed with acetaminophen (Tylenol®) as directed
Precision Targeting
Using KOELIS navigation with MRI-ultrasound fusion plus micro-ultrasound detail, we map, target, and sample lesions with ultimate precision — improving diagnostic yield while avoiding unnecessary cores.
Aftercare & Expected Symptoms
- Mild soreness at the skin entry site is common; use Tylenol as instructed.
- Small amounts of blood in urine or semen can occur and typically resolve on their own.
- Hydrate well for 24–48 hours unless told otherwise.
- Call us immediately for fever, difficulty urinating, or heavy bleeding.
Advanced Genetic & Methylation Testing
We send samples for advanced genomic analysis so you and your care team have the fullest picture possible.
If the Biopsy Is Positive
We add MDX Health GPS testing to assess tumor biology and help guide next steps. This provides additional prognostic information beyond standard pathology.
If the Biopsy Is Negative
We can order ConfirmMDx (methylation testing) on the negative cores to detect epigenetic changes that may signal occult cancer, helping decide if further monitoring or repeat biopsy is warranted.
FAQs
Will it hurt?
We perform most biopsies under anesthesia in our ASC — you should not feel pain during the procedure, and post-procedure discomfort is usually mild and controlled with Tylenol.
What about infection risk?
The transperineal approach avoids traversing the rectum, which reduces infection risk compared with traditional transrectal techniques.
How long until results?
Pathology typically returns in several business days. Genomic and methylation tests can take longer; our team will update you and review the plan together.
Do I need to stop my medications?
We will give individualized instructions for blood thinners and other meds before your biopsy. Please do not stop anything without guidance.
Ready for Clarity?
When accuracy matters, technology matters. Our KOELIS navigation and micro-ultrasound workflow deliver a precise, comfortable prostate biopsy — and our advanced testing ensures you have the most complete information.
Your plan is personalized to your PSA, imaging, and medical history.