@jayhall -- not necessarily. I was prescribed a fleet enema for my fusion transperineal biopsy. I believe they want the bowel empty since they still put an ultrasonic probe up your rectum to light up the prostate for placing the needle.

I will second jeffmarc’s comments: be SURE it is trans perineal otherwise they are not getting to distant parts of the gland which may have the cancer and you may wind up with another false negative.