MRI-guided transperineal biopsy hurt so much

[Gus_Tec]

I'm curious if folks have recommendations about how to reduce what was an unbearable pain from the biopsy. I almost passed out and the thought of my next biopsy gives me cold sweats. What hurt was the process of the anesthetic injections. Each one at a deeper layer. It's clear that the anesthetic did its job as I didn't suffer much from the actual sampling. Clearly everybody is different. And I assume it would have hurt less if he'd waited longer between each round of injections to allow. But, did you anyone experiment with oral medications, valium, or anything to reduce the unease? Anybody that did this repeatedly might be particularly helpful in providing guidance here? Thanks.

[Tall_Allen]

I agree that slowly adding the lidocaine is the key. That's true for both transrectal and transperineal.

Because it's relatively new, I think there is a learning curve that doctors have to go through.

[Gus_Tec in reply to Tall_Allen]

Thanks. I guess I'm wondering whether oral meds or valium might help b/c at least in my case I didn't feel like the doctor, who had done many of these before, felt it was reasonable to slow down given his schedule. I'm also pretty sure he's never had a biopsy done to him either.

[allie2020 in reply to Gus_Tec]

I have had two transrectal biopsies. The first was in 2012 and I was wide awake. The pain from the anesthesia injections and from the sampling injections was severe, I mean certainly 9 out of 10. My second trus biopsy was in 2018 by a different Uro and I told him I wanted to be under anesthesia. I was and of course felt nothing. I would never want to repeat the pain I felt in the 2012 biopsy ever again.

[Gus_Tec in reply to allie2020]

That seems like a reasonable option that was never even mentioned. I don't know if it's possible here in Canada. Thanks.

[addicted2cycling in reply to Gus_Tec]

Tall_Allen wrote -- " ... Because it's relatively new, I think there is a learning curve that doctors have to go through. "

If T_A is referring to a Transperineal Biopsy being *new*, the procedure has been around for awhile ---

ncbi.nlm.nih.gov/pmc/articl...

I've had 2 TRUS biopsies with the first 10+ years ago and no lidocaine and was told it would be 12 but attending nurse did not care for samples so wound up 4 extra at 12 pain out of 10. 😂- NOT. The second, by a different urologist, was with lido in 2015 by Urologist and better but still smarted. Then less than 2months later I had Dr. Gary Onik's Saturation Transperineal 3D Prostate MAPPING Biopsy under a general = 100+ core samples for biopsy and FELT NOTHING. Second 3DPMB was 3 years later also under general and FELT NOTHING. The need for a general is eliminated when performed by a skilled Dr. using Precision Point --

perineologic.com/precisionp...

[caysary in reply to addicted2cycling]

It's been around yes but health care providers avoid it due to costs and so that is why many doctors are not trained properly in Transperineal Biopsy. They always opt for the easy route.

[Mcrpca]

As a clinician, pain with local anesthetic injection is directly related to the speed of the injection. Ask them to inject slowly the next time.

[Benkaymel]

My transperineal biopsy was performed by a lady urologist who was clearly experienced. No pain from the local anaesthetic jabs and only one of the sample shots stung a little. Also had no after effect problems from it.

[turkeyjoe1]

I had my one and only one at a major cancer center. The URO promised no pain. They took 18 cores, by the 16th one I promised him I was coming after him. They ran out of the room before I could get off the table. Get a general, these guys have no clue what it feels like.

[WilsonPickett]

Insist that they put you to sleep before it even starts. I wasn’t even present for mine. Made the experience a whole lot more bearable

[Alexandr1]

I took a Xanax and had music headphones with some of my favorite tunes. Hardly noticed the procedure. I always ask them NOT to tell me what’s happening, I simply zone out with the med and Surround Sound…..

[Atdabeach]

Gave me Valium (or maybe Xanax) before placing my fiducial beads before radiation. I was more relaxed, but it was still quite painful.!

[MikeyVilla]

I'd say both mine were painful but I always tell people: not worse than root canal surgery! That is the injection for the anesthetic is the worst part. One funny but useful thing, when the assistant asked me if I wanted to look at the computer screen, I said "No, I'm not here, I'm on a beach somewhere". I really think some effort to focus on more pleasant things, not what is actually happening, helps

[Murk]

I had no pain, but it was a bit uncomfortable. I jumped once when a sample was taken but it was more of reflex issue. Not sure what he used to eliminate pain but it worked well.

[Muggs1]

take Tylenol 1000 mg prior; I had some hydrocodone so took that too. My doc px Valium but I wanted to drive so didn’t take it.

[j-o-h-n]

No nuting for biopsy. Uncomfortable especially when my urologist kissed me on the lips...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 07/20/2023 6:10 PM DST