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After your prostate biopsy

Blood in Urine and Semen — After a Prostate Biopsy

Seeing blood after a prostate biopsy is frightening, especially when it reappears in semen weeks later. Most of it is expected and settles on its own. This page explains what is normal, how long it lasts, and the signs that mean call your team today.

Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026

  • Blood in urine is common — It usually clears within a few days as the biopsy sites heal.
  • Blood in semen lasts much longer — Haematospermia — blood in semen — can appear for several weeks after the procedure and is expected.
  • Fever is different — A temperature, chills, or feeling genuinely unwell after a biopsy is never normal and needs a same-day call.
  • Most men are not warned — Blood in semen is under-discussed in pre-procedure counselling and often comes as a shock.
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Blood in urine and blood in semen are both expected after a prostate biopsy. Blood in urine usually clears within a few days. Blood in semen — haematospermia — can appear for several weeks and does not mean something went wrong. Call your team if you develop a fever, cannot pass urine, or notice heavy continuous bleeding.

Is blood in urine normal after a prostate biopsy?

Yes. The biopsy needle passes through tissue containing small blood vessels, and some bleeding into the urinary tract is expected. You may notice pink or tea-coloured urine, or small clots, in the first day or two.

This settles on its own for most men within a few days. Drinking plenty of water helps flush the urinary tract and keeps the urine lighter in colour.

If the bleeding is heavy and continuous — bright red urine that does not lighten over a day — or if you cannot pass urine at all, contact your team the same day.

How long does blood in semen last after a prostate biopsy?

Blood in semen — haematospermia — is the aspect of prostate biopsy that most surprises men, because it lasts far longer than blood in the urine. Semen passes through the prostate on its way out of the body, so blood from the biopsy sites gets mixed into it.

This can continue for several weeks after the procedure. The colour may range from pink or brown to darker red. It does not mean the bleeding is still active or that something has gone wrong.

It settles without treatment and requires no special management at home. Your partner is not at risk. If it has not improved at all after many weeks, mention it at your next scheduled appointment.

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When is bleeding after a prostate biopsy a warning sign?

Fever, chills, or feeling genuinely unwell in the days after a biopsy is the sign to act on urgently. Infection is the most serious complication of prostate biopsy and it can develop and worsen quickly. Do not take paracetamol and wait to see if the fever settles — call your team or go to hospital the same day.

Also call your team urgently if you cannot pass urine at all, if you have heavy and continuous bright red bleeding that is not slowing, or if pain is increasing rather than settling.

Mild burning when passing urine and brief rectal discomfort are common for a day or two after a transrectal biopsy and are not warning signs on their own. A worsening pattern — any symptom getting worse rather than better — is what changes the calculation.

Words on your discharge sheet explained

Haematuria
Blood in the urine. After a prostate biopsy this is expected and usually clears within a few days. Pink or tea-coloured urine is normal; bright red urine that does not lighten, or clots that seem to block the flow, is the sign to report.
Haematospermia
Blood in the semen. This is the most common unexpected finding after prostate biopsy. It can persist for several weeks, resolves on its own, and requires no treatment. It does not harm a partner.
Haematochezia
Blood passed from the rectum or seen on tissue. Small amounts are possible after a transrectal biopsy, where the needle passes through the rectal wall. It usually settles quickly; persistent or heavy rectal bleeding needs same-day review.
Transrectal biopsy
A biopsy route where the needle enters through the wall of the rectum to reach the prostate. It carries a small risk of infection from rectal bacteria entering the bloodstream — your discharge advice will describe the signs to watch for.
Transperineal biopsy
A biopsy route where the needle enters through the skin between the scrotum and anus, avoiding the rectum. Your urologist will discuss which route is appropriate for your situation.

Did you know?

Blood in semen after prostate biopsy is one of the most under-discussed side effects of the procedure — and one of the most alarming to men who were not warned to expect it.

EAU (European Association of Urology) guidelines recognise haematospermia as a common and expected finding after prostate biopsy that typically resolves without any intervention.

Source: EAU Guidelines on Prostate Cancer — Diagnostic Evaluation

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Common questions

Frequently asked questions

Why is there still blood in my semen weeks after the biopsy?

Semen is produced partly in the prostate and passes through the gland on the way out of the body. Blood from the biopsy sites gets mixed into seminal fluid each time you ejaculate. Because these sites heal gradually from the inside, this can continue for several weeks. It does not mean the bleeding is still active or that lasting harm was done. It resolves on its own.

Does blood in semen after a prostate biopsy mean the cancer has spread?

No. Blood in semen after a biopsy is caused by the needle punctures in the prostate tissue, not by the cancer itself. It is a procedural effect, separate from what the biopsy found. Your results — whatever they show — are a different matter entirely, and your oncologist or urologist will discuss them with you. If you are waiting for results and feeling anxious, calling the clinic to ask when to expect them is entirely reasonable.

When is it safe to have sex after a prostate biopsy?

Most discharge guidance suggests waiting at least a week, though your team may give you a specific timeline based on how your recovery is going. Haematospermia — blood in semen — can continue for several weeks and does not make sex unsafe for you or your partner. Resuming before any swelling or discomfort has settled may simply be uncomfortable. Follow the advice on your discharge sheet, and ask at your follow-up if you are unsure.

Could I have an infection — what are the signs to watch for?

Fever, chills, shaking, and feeling genuinely unwell are the main signs of infection after a prostate biopsy. This can develop within a day or two of the procedure and can escalate quickly. Do not take paracetamol to bring the fever down and wait to see if it settles — call your team or go to hospital the same day. Urinary symptoms that are worsening, rather than mild discomfort that is easing, alongside any of these signs also need prompt attention.

My discharge sheet says to watch for heavy bleeding. What counts as heavy?

The pattern matters more than the colour. Pink or tea-coloured urine that is gradually improving over a day or two is expected. Bright red urine that is not getting lighter, or clots that feel like they are blocking the flow, is the sign to call your team. Difficulty passing urine at all — even without visible blood — needs same-day assessment, as a clot lodged in the bladder can cause retention. When in doubt, call rather than wait.

Will the blood in semen affect my partner?

No. Blood in semen from a prostate biopsy poses no risk to a partner. It is not infectious and does not carry anything from the procedure or the cancer that could affect another person. Many couples find it helpful to know this before resuming sexual activity, because the appearance can be alarming when it is not expected.

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What Is a Biopsy?

What Is a Biopsy? Everything You Need to Know →

Types of Biopsy Compared

Which Biopsy Will You Have? Techniques Compared →

Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

After a Biopsy: Recovery, Aftercare and Warning Signs →

Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

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IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

Cytology & Prostate Scoring Systems Explained →

How Accurate Is a Biopsy?

How Accurate Is a Biopsy? Errors and Second Opinions →

If Your Result Is Benign

Your Biopsy Is Benign: What It Means and What Comes Next →

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