I have concerns about the discomfort and after-effects of a prostate biopsy scheduled soon. But my urologist seems to be saying "No worry. It'll only take 30-40 minutes and it'll be over so that you can return home. You'll have some soreness for a few days and you'll be okay."
Is this the real deal about prostate biopsies or is my urologist "painting a rosy picture" of them?
I felt a bit more discomfort than I was expecting. Not terrible but more than what my urologist told me to expect. I think he said to expect pain level of about 3 and I would say it was level 5 or 6. The procedure itself took about 10 minutes. I rested about 10 min afterwards and drove home. No real discomfort afterwards. I remember him saying that a small amount of blood in my urine was normal but I didn’t have that.
I had my prostate biopsy under IV anesthesia. When I woke up 30 minutes later, no discomfort. Intermittent blood in urine for about a week. Blood in semen for around 2 months. Otherwise, no side effects.
The only anesthesia I had was a local injected directly into my prostate.
The same and ONLY slight discomfort .
me too! My first set was during a green light laser procedure for BPH (Gleason 9, only on one side). My second was 2 years later after cryo-oblation. They tried to talk me out of anesthesia and told me only 1 in a 1000 men were anesthetized. I then told my urologist, as a research surgical tech, we trained urologist on the biopsy instruments when they first came out. Every time they discharged, the techs all jumped. Do you really want to chance that. The real bonus is while I was asleep he took 18 biopsies. PS I learned I was a Gleason 9 on both sides…
Hey thanks--this is really encouraging!
I was anesthetized, so didn’t feel anything. Drove home with minimal pain. Had mild pain and discomfort for a few days but no real pain. Had blood in urine for a day or two. But overall no big deal.
Thanks Jack54. Were you able to walk okay without pain?
Yes I was. Just some very minor discomfort.
Why did they allow you to drive home after anesthesia? My husband had deep sedation and I needed to pick him up afterward. He had FELT like he had been asleep, although he was just deeply sedated. And enough that he should not operate a vehicle right afterward.
Sorry, meant rode.
Phew. That’s more like it! ☺️
Sometimes my brain doesn’t always agree with what I think I’m thinking.🤔
😁 Hey, I don’t even have an excuse for my “brain farts”. Maybe old age? I usually can’t remember what I went into a room for moments ago. 🤪
Your urologist's description of what to expect was my experience. No general anesthesia. 14 cores - I do recall the snip snip snip. Whas apprehensive, but in the end it was no big deal. I was concerned about infection risk. It's probably relevant that I was on hydromorphone at the time because of the metastases to my spine. I think I also had a local but I can't remember now.
He should use a local to the prostate. I hardly felt a thing.
My was done with IV anesthesia. Propofol I believe, like they use for colonoscopy so I felt zero discomfort during procedure, didn’t know it was happening till it was over. Mild discomfort for a few days after. Go for the iv anesthesia instead of the other thing some docs use, nitrous oxide I believe, where you remain conscious during procedure.
My biopsy was about two years ago. I too had apprehensions and worries about multiple needles thrust into tender zones. I was given a local shot to deaden the area and the samples were taken in about 10 minutes. I still remember the sample needles making the sound of a defective staple gun as each core was detached. I walked out of the procedure room with little discomfort and no residual pain. I peed before I left the clinic and passed a couple of clots. Urine was discolored for 2 days. Not a horrible experience.
Hey, thanks for the encouragement! This sounds like the "music" I want to hear.
The music you want to hear is "yes we can do IV anesthesia". Easy peasy.
Having a biopsy was one of several "suck it up buttercup" moments for me in my PCa treatment arc. For those of you who aren't up on your idioms, such moments are full of anxiety and the sorts of fear that are 99% groundless. Or to quote the famous shoe maker, "Just do it." Want to know about the most intense "suck it up buttercup" moment for me? Getting radiation treatment for 20 consecutive weekdays with exponentially worse side effect accrual. In comparison a biopsy was a baby's kiss.
Similar to mine? After 10 of scheduled 28 sessions, I am experiencing horrible urinary frequency, bladder not voiding properly, the last 2 days minimal successful bowel movements and emitting a saliva looking ooze when straining for bowel movemnt...even while continuing to imbibe my normal serving of Miralax that I have been using for the past years or so to help with longstanding hard stool constipation problems. Horrified this is happening and only 1/3rd done with this !! RO said this was very early to be experiencing the urinary problems, so he order urinalysis to look for UTI. Results 1st sample were inconclusive , and a culture test result was " contamination".....result for test of another sample today was normal for all items listed in urinalysis results. Often, I am peeing evry 30 minutes.....horrible sleep to say the least!! Used Flomax one nite, but the next day for 2-3 hours experienced way below normal BP for me with queasiness and weariness. Another Doc told me to drop the Flomax for at least 2 days, until UTI situation was answered. I guess I'd then give the Flomax another try, hopr the SE sysmptoms don't reoccur. Almost certain the Flomax helped the one nite I used..even slept approx 2 hrs ...twice!!!
Any of this sound familiar, or your problems entirely different>
THANKS!!!!!!!!!!!!!!!!!!!!!!
P.S. Another 4 weeks dealing with this????
Did your RO require empty bowels for every RT session? At any rate, I was blessed to have a less exciting experience. You have our sympathies and prayers.
Al I know that he has dscussed the importance of that, and he monitors that daily post-session, with I guess feedback to the techs if he sees any problems when looking at that days' CBCT images. Once per week, he reviews CBCT before approving beam on...so that is good. he also said, evry day he reviews past 4 days CBCTs for comparison to planning CBCT. They are using my calcium deposits as a substitute for fiducials. Bottom line, Friday he said things are going well.....I guess a reason he questioned that the RT was causing my urinary problems aafter only 10 completed of total 28 sessions to be done.
AS I review the long list of possible problems with both RT and ADT, all my problems are possible outcomes...LUCKY winner I guess?
Hey , after 1 month of ADT, should I celebrate that no hot flashes, or that comes later? I think I'm getting hot more easily, but not flashes!
As for the biopsy, mine was pretty uneventful at MDACC. Was taken to an exam room with the biopsy equipment that had a little bathroom off the side, asked to disrobe from the waist down and put on a gown. Was also handed an enema to self administer while standing over the toilet, hold for some time period and then let 'er rip. Next was one antibiotic pill and a bit of water. The nurse left and came back with the clinician? that performed the biopsy (mine was 12 cores with fused MRI). Laid on my side on the table, given a local to the prostate, and was told to expect a little stick each time she grabbed a core. The urologist also attended and chatted with the person doing the biopsies mostly about the new equipment she was using. The nurse quipped I was lucky to have the "dream team". Very little pain during or after and no blood in urine or stool.
As to maley2711, I also had lots of bowel issues with alternating diarrhea and constipation over the 2 months of treatments. I did have spaceoar, but I guess the low dose to my bowels still caused me problems. I already had urinary problems and was taking 2 flomax a day and the radiation didn't seem to change that much. I'm 1-1/2 years post radiation and still taking a flomax every night and up 4 to 5 times during the night.
All-in-all just some discomfort from the disease, diagnosis, and treatment in exchange for added years of life. I've been on ADT since July 2022 and looking forward to stopping that in a couple of months (at least until my PSA and/or further scans indicate it's time to start up again). You just need to take it day by day and count down to your last day of treatment. I used mindfulness meditation to get through the entire diagnosis and treatment process. Whether sitting alone in a waiting room, getting an IV, being embodied in a banging MRI, laying on the the radiation table waiting for the final OK-to-go between the pre-radiation CT scans and the radiation (please no gas or poop...), or any other stressful part of this experience, I just used the basic mindfulness techniques to get by minute to minute. I consider myself lucky that unlike most of my "proton partners" at the treatment facility, I was not getting the balloon up my butt 38 times. One of my buddies didn't even tell his wife or other family fearing the jokes for the rest of his life.
What side effects did you have from the radiation treatments?
My husband had minimal side effects during/after his 28 radiation treatments. Mostly he had some narrowing of his urine stream and just had to get up to pee one more time at night. That’s resolved or very close to it.
Hey, sounds like the "anxiety over it" is worse than the procedure itself.
I had two, no anesthesia, did fine: concur with others.
Looking back, I would be asking the doc if he is certain he will be sampling the worst bits of tumor based on mpMRI findings (mine missed and Gleason and genomic scores were incorrectly lower than actual).
Also, I would be seeking independent second pathology opinions and genomic testing of biopsy samples.
I have a high pain threshold, so no problem about pain, I had been writing a book about Edinburgh for a number of years, I mentioned this to the Doctor doing it [strong Scottish accent] for the rest of the procedure Edinburgh this, Edinburgh that, the two accompanying nurses looking at each other🙄😵🙃, I found it a fairly basic procedure😁🙄
research transurethral biopsies, as those have much less risk of infection and side effects. Also, most Center of Excellence hospitals now do an MRI first to see what that shows, and the. Aim the biopsy needles at areas of concern, rather than just Random
Well, what to say here? Had my core biopsy in a regional but still 'high quality' medical part of Australia (East Coast basically, not to say Perth, lovely WA regions and Adelaide plus regions in SA are poor cousins). I have peritoneal mets at 12 - 13 years in now from DX, diagnosed 2 years ago. RO thinks likely comes from Da Vinci 3D surgery 12 years back in Melbourne with well known surgeon - dragging small tools back through small holes, causing internal 'litter' and cancer 'seeds' long term. BUT could easily have happened at core biopsy. I would try to stay away from all surgery (including core biopsy) if your ultimate choice is radiation or brachytherapy or some other non-invasive principal therapy. If surgery is your choice and available as principal therapy, then there is no reason to avoid the biopsy. Also have to add, could have been that the cancer travelled via lymphatic system to gut area, but we do think unlikely. So be careful of your choices. I am still well, but will undoubtedly be terminal.
Your urologist is right. I had the biopsy and slight discomfort for a few hours.
Questions like this makes me wonder why a lot of people on this forum seem to doubt healthcare professionals . I agree that sharing experiences can be a good thing, don’t get me wrong but I sometimes see responses to questions about treatments that people shouldn’t post. When in doubt about a treatment, get a second opinion from another doctor. They know best , years of study , experience and treating other patients has more value imho than the personal opinion or experience of a few individuals.
It reminds of the stories we probably all heard about grandpa who smoked all his life and never got lungcancer ….
i had only local anaethesia , rectal , and then 12 cores. I went then quickly home to rest and support the pain when anaethesia stopped working. Next day was ok, except of the psychological shock in the evening that i had Gleason 3+4 and had PC !
Standard of care these days from an oncologist is an MRI first and then if necessary a biopsy. The urologist does not get paid as much for a biopsy. By all means request an MRI first as there is certain risks involved like infection with a biopsy.
If you want treatment for your cancer start believing your Oncologist and other specialists. They will only tell you the truth. If they feel they need to, then they may be more optimistic on occasions but only to benefit you. They need you to be honest with them. By all means ask others here about their experiences but don't be frightened to tell your oncologist if you are worried he is being overoptimistic and give him chance to reply. Ask what are benefits of biopsy and what are implications if you don't have it. Then decide.
Get the biopsy. Like you I stalled for several years after a biopsy was recommended. When I finally got the biopsy I had a Gleason score of 9 and surgery was not an option due to the size and location of the tumor. I’m now being treated with Lupron, Zytiga and Prednisone.
Good luck.
Thanks Peealot (hope no more)! Looks like it's best to get it when recommended rather than putting it off.
That’s your best next step. I wish I had acted sooner. You’re welcome.
What tests have you had previously or symptoms causing the need for a biopsy? I didn't see anything in your bio or posts over the last few years here. Have you seen an oncologist yet?
I had mine (a trans-rectal one) done under general anesthesia. Woke up as they were wheeling me back to recovery room. No pain. Had to pee before they’d discharge me, and managed to perform, with minor blood. Blood in ejaculate (the one time I was curious), but generally no problems.
Try to get a trans-perineal rather than trans-rectal biopsy. No need for a GA and much less risk of infection. Mine too about 20 mins under local, pain no more than 3. Drove home and wouldn't have known I had it done the following day.
It's not a rosey picture other than the rose color blood you're going to pee for a dar or so. No worries it's not that bad at all the bad part is getting your results. Best of luck Never give up Never surrender Leo
It is zero to worry about. The only thing to worry about is results and almost everyone will have a bad health result at some point. Even good results are sometimes just a miss. Tempus fugit. Best wishes.
He is right it's no big deal but I would request you be "under" during the procedure. I had "twilight" not full anesthesia.
There’s a machine here in San Diego called Tesla 3….It takes a 360o picture of your prostate…If cancer is shown THEN you do a guided biopsy with only a couple needles because the radiologist knows exactly where to go for samples….You are in La La land and don’t feel a thing….Much better IMO than a lot of needles up where the sun don’t shine and just hoping to hit something…Other facilities must have this machine….its in La Jolla Ca….
I had a T3 MRI done AFTER my 12 core biopsy; the MRI showed nothing, whereas the biopsy showed 3+4 in 10% of one core. My point is, if I'd had the MRI done first and based a decision of whether to biopsy, I'd still be in the dark. The biopsy was done under general anesthesia BTW, after I could not tolerate the first attempt my urologist made to do it as an outpatient procedure. Her remark at that time was "Well, THAT'S not happening!"
Additionally, the residual discomfort and side effects of the biopsy were indeed minimal.
Definitely get anesthesia, my first 2 biopsies were only with anesthesia to numb the prostate, it was still very uncomfortable kinda what I imagine a prison rape is like (I wouldn’t know) and the ride home sitting in the car was extremely uncomfortable. My 3rd biopsy was done by a different urologist who gave me some Percocet beforehand and it was much more bearable. I know some guys who were totally out for it from anesthesia and I would have opted for that if I had the option, and I’m not a pussy when it comes to pain tolerance.
Afterwards expect soreness, some blood in your stools and most shocking…blood in your ejaculate. All this being said, don’t put off getting one, it can be the difference between catching it early or allowing it to go metastatic.
And when your urologist says it’s easy, ask him if he’s ever had one.
Ed
My biopsy was in last 2023. With local anesthetic, it was over soon in the doctor's office. It was a bit sore for a few days but was not a big problem.
However. The next day I was in the middle of a tour of an assisted living home when I developed a massive hemorrhage. In the hallway, I felt something running down my leg. It wasn't urine, it was blood. It soaked both my inner thighs, socks, and ankles. To prevent blood from getting on the seat, I promptly left for home and made do with sitting on a pile of newspapers in the car.
I assumed this was more or less normal since the doctor had said there would be blood. It subsided after a few days.
I think the problem arose because I am taking apixaban (Eliquis) for atrial fibrillation. My cardiologist and urologist both directed me to resume the day after the biopsy. Perhaps I should have extended the bridge replacement for a few more days.
I have been on ADT since February, and finished my five SBRT sessions in mid-May. My cancer was level 5, Gleason 9 on six cores and 6 on another. I think I am on track for recovery from the diverse side effects by mid-summer, 2024.
All in all, it is working well.
You will see some blood in the urine for a day or so as well. The prospect of catching PC earlier and having simpler treatment options far outweighs the modest discomfort. My Urologist delayed mine 18 months....and ended up GL 9 Stage 4. Not the way to go.
Local anaesthetic, with 13 cores taken. A little blood but I rode home on the motorcycle with no issues. Uncomfortable, with the anaesthetic being the worst part.
I had PSA of 30 and no other symptoms, Pca was picked up purely by chance!
DRI also indicated a problem, MRI and Bone scan both clear.
Biopsy was necessary to confirm cancer and get Gleason score before starting treatment., 4+4.
Up until the biopsy my water flow was totally normal, after the biopsy (June 2023) my water was never the same again. Since that time I have been suffering from nocturia and have left the marital bed to save disturbing my wife too much, fortunately we have a guest room with en-suite.
My PSA now after radiation treatment and HDR brachytherapy is 0.01 so very happy with that, but my nocturia still shows little sign of improving.
Normally I wake 3-4 times a night, I have been told it can take several months or more to get back to normal, I yearn for an undisturbed night.....that's my slightly negative story, but with a positive Pca outcome.
Good luck
Try a Holistic Health approach and let your wife/girlfriend sit in for you......If that's not feasible insist that the doc gives you an I.V. anesthesia (most docs don't like to knock you out....- they earn less bucks that way). I had mine ice cold and took it like a macho man........I cried my ass off....
On this Memorial day, I honor and mourn all those who proudly served our country.
Good Luck, Good Health and Good Humor.
j-o-h-n
I was offered valium or nitros for my transrectal biopsy. I chose valium for the first one. Not really a big deal. A few uncomfortable "pinches". No real side effects I can remember. Drove myself home fine.
The second one was a directed biopsy since my PSA doubled in 6 months. Again a transrectal, despite my asking about a transperineal, hearing that it was safer. The Urologist said they are equally safe. This time I chose nitros, but had never had it before. It seemed to only make me a bit dizzy. The pain was similar in intensity - tolerable. I got sepsis from that 2nd transrectal, though I describe the cleanliness of that office as a "Waffle house." After 5 days in icu a got out. Apparently I had a sever UTI that went septic.
The next entrance was the placement of the OAR barrier prior to radiation. This was done perineally. It was more bit more uncomfortable, lasted longer and I remember saying "ow" once. Again I used nitros and wonder what it did. I suffered no side effects from that procedure.
I had 45 days of RT + 6 months of Eligard. I'm 6 weeks out from the last shot of Eligard, still getting hot flashes, urinary issues, waking 4-6 times per night and larger boobs and smaller penis. But subsequent Pet scan shows no PC for now. We believe I caught it before it exited the prostate (Gleason 3+4). So technically, the best I can say is I'm in remission - for now.
The biopsies are not a big deal. I would not do a transrectal again. I will look around for a skilled DR. who can do that.
As clean as a Waffle house? <---------- laughing my ass off (thanks - writing that one down)...
On this Memorial day, I honor and mourn all those who proudly served our country.
Good Luck, Good Health and Good Humor.
j-o-h-n
There are so many replies, I am not even sure if you will see this, or if this redundant.! That said, I strongly believe that the moral to this story is anesthetic. I had local anesthetic for a 12 core transrectal biopsy, and it was largely a non-event. Later I had 3 fiducial markers implanted in the prostate, necessary for radiation treatment, an additional transrectal procedure without any anesthetic, and it was incredibly uncomfortable. I will never consent to another such procedure without at least local anesthetic. Please be forewarned!
another consideration regarding biopsies, MRIs, or future treatment. There will be various opinions from brilliant doctors. and this is coming from a man who’s been to all the major cancer hospitals, City Of Hope, Mayo Clinic, UCLA, Cedar Sinai, and a few others. It’s always the same. The first visit is very thoroughly researched and comprehensive with probably an hour spent with the oncologist. after that, your future 15 minute appointments with your oncologist are spent mostly by them typing in their report for their weekly tumor board instead of listening to you. If you are not thoroughly educated prior to your appointments, they don’t have the time to educate you. That’s what’s good about this site. Print out 10 questions and email them a few days ahead of time for your oncologist to review. They almost never do. You’ll be lucky to get them to do it while you’re sitting there. Be prepared to write everything down. They mean well, but they’re overwhelmed. Remember, you are your own best advocate
There are quite a few learned men here like doctors and scientist who also have prostate cancer and are able to kick around the current research and discuss and translate for us.
Lastly. If you are not busy heavily exercising... Whatever the treatment ahead, start training now harder than you ever have in your life. Good luck, my brother.
My husband had his biopsies after diagnosis and it was piece of cake. For one thing, he was deeply sedated. Even though it wasn’t general anesthesia, he felt like he was asleep. Didn’t feel a thing. He just had some bleeding afterward in his urine and semen. No discomfort or pain. When the urologist inserted the gold fiducial markers and Barrigel later prior to radiation treatments, he had the same deep sedation. Again, no pain whatsoever.
I don’t know what any urologist wouldn’t sedate a man before doing biopsies or any invasive procedure. I’m not talking about just a local anesthetic, either. Actual sedation with drugs that causes deep sleep and you can’t drive home afterward.
Don't take anything resembling a blood thinner for several days or a week prior. It was like experiencing bee stings that did not linger. No infection, no side effects.
my urologist used Novocain, and I had minimal discomfort.
If you have not had an mpMRI I would before having a biopsy done. With the 3 Tesla MRI machines which are common now days it’s an easy and valuable scan. The older prostate MRI (1.5 Tesla power)used a coil inserted into your rectrum. Some radiologist still prefer this method.
My biopsy experience was tolerable. Just a shot to numb the prostate. No side effects.
I didn’t even ask about anesthesia, but if available I would have probably opted for it.
A small 'bee sting' for the anesthesia to the prostate. The biopsy tool is a bit loud when it makes a 'clack' sound with each punch. Whole thing took maybe 20 minutes. Not fun, but very doable. Some residual blood in urine for a day or two. Deep red blood in semen was a bit disturbing, but I was warned. That took several weeks to go away. My urologist did offer the option of nitrous oxide. Insurance won't cover it and I paid $100 for it. Did I 'need' it. No. But, it was a nice distraction to just suck on a little tube for a little nitrous to take your mind off it for a bit.
Just had a transperineal biopsy last week. It's uncomfortable, somewhat painful, but definitely tolerable. It was done by a urologist at Cedars Sinai Hospital in LA. Here are their instructions:
Before Procedure:
1) Stop taking aspirin and all blood thinning medications ten days prior to the procedure (They provide a list of blood thinning medications)
2) Twenty-four hours before the procedure you should avoid any foods that tend to give you gas because gas can interfere with the procedure.
3) Purchase an over the counter fleet enema and utilize it two hours before the procedure.
4) Do not have any alcoholic beverages twenty-four hours before the procedure.
After Procedure:
1) Blood may be noted in your urine and/or stool for a few days and in semen for up to one month. It is important to drink at least 6-8 glasses of liquid per day for 5-7 days to minimize the amount of blood in your urine and to prevent clots from forming.
2) Sitting in a sanitized tub of warm water and taking Tylenol will help to alleviate any discomfort you may experience.
3) DO NOT take any aspirin or other blood-thinning medications for at least three days after the biopsy, unless your doctor has specified otherwise.
4) DO NOT engage in any sexual activity for three days after your procedure.
) DO NOT engage in any sport, work out in the gym, ride a bicycle, or lift any objects heavier than 10 lbs for three days following the procedure.
I can't speak to why they have developed the above lists. In my case there has been no pain and no blood in my urine and/or stool after the procedure. I went along with their suggestion to not engage in any sport, work outs at the gym, and lifting for 3 days after the procedure.
I have a high tolerance for pain, but I definitely was not prepared for what felt like a pipe shoved up my ass with what felt like an industrial grade staple gun attached to the end every time the urologist pulled the trigger. I guarantee you that every person in the waiting room heard me after the first pull of the trigger.
Well my experience was very different. I had the biopsy through the rectum with anesth. I think he put the forceps on my hemohroids and stretched them to my prostate. It was so painful, I trembled involuntarily. Afterwards it was a relief, bleeding etc.. but just a little painful. My guess is the replies had a Transperineal Biopsy. I had a transrectal biopsy. Never, never again!
I didn’t think it was more than routine. The doc said, as usual, “You may feel some discomfort, “ which I did. Then I went home. Little or no pain after. What was important was that the info gained was very important. I recommend that you spend your time thinking about something more important than the procedure—e.g. the results of the test.
I have had 4-5 biopsies the ones under general were the easiest and I highly recommend them. However the last one I couldn’t urinate after and it was hell. I was told it was most likely caused by the anesthesia.
I had the local anesthetic shot beforehand, the biopsies felt like something tapping slightly hard on me, and I felt no soreness afterwards. The awkwardness of it all was worse than the discomfort. 🦊
Not fun but mostly bearable. In my case they hit a nerve which sent me into orbit. That is rare.
I have had 4 transrectal prostate biopsies performed over the last several years. The insertion and movement of the ultrasound probe was fine. Mildly uncomfortable but definitely tolerable. I have likened the process of sample taking similar to the sound of a cheap five and dime cap gun! Not painful and almost comical to listen to. What was painful was the initial injection of lidocaine to numb the prostate. A friend called this "blindingly painful" and I would have to agree. You only feel it once, though. After that initial poke, you are numbed up. Interestingly, I felt that pain on 3 of my 4 biopsies. During my last biopsy, I did not feel that pain, at all.
Unsure of best option in early prostate cancer diagnosis.
so my fellow shipmates i'll tell you me C story
What about my dad's prostate treatment?
Aggressive form of prostate cancer PSA 11.8 and Gleason score 9.
