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What does a transrectal prostate biopsy feel like?

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Posted 11/7/2010 6:12 PM (GMT -5)
rgmjr, for me it was an absolute "piece of cake". Mine was accomplished in the local hospital OR under anesthesia and the after effects were nothing at all for me. I was on the OR table almost asleep when they brought these two big mechanical apparatuses over to the table and I just barely remember thinking/wondering, "what the hell are those things for?"
Didn't find out until well after the procedure that they were stirrups. I have a cousin who went through the same procedure but in his Urologist's office without the benefit of any pain numbing meds and he too said it was nothing at all and the very worst thing was hearing that snap of the core cutter. You'll do just fine so don't let the though of that biopsy rattle you. Worst part will be getting completely cleaned out and not being able to eat prior to the procedure.
about five months later on May 26 of this year, I had brachytherapy performed at the Chicago Prostate Cancer Center, Westmont, Illinois and it was truly just as easy as the biopsy.

Post Edited (erbob) : 11/7/2010 4:18:59 PM (GMT-7)

Posted 11/7/2010 8:37 PM (GMT -5)
I had a twelve core at Hopkins without anesthesia but they may have used some lidocane cream.  It really was nothing much, just a slight pinch for every core.  Got up, wiped up, and went to work.  There was some blood in my urine for a few days but no bowel problems or anything like some of the other horror stories I've read.  My first 12 core was done under anesthesia by my local urologist so I was pretty worried about the pain, especially when my urologist asked "why aren't they giving you anesthesia?  So happens most doctors don't think it justifies using propofolor something similar.  It just never materialized into anything memorable to speak of.  Maybe the topical anesthetic was the trick?  Maybe you can ask for that.  Try not to worry.  It will be over in 10 minutes at most.  The real worrying starts after that.  Good luck and I pray your cores are all negative with no atypia or high grade PIN that may require a redo in three months or so.  Take care.
Posted 11/8/2010 5:41 AM (GMT -5)
Reports here about biopsy experiences suggest we're all very different.
I was done lying on my left side.
I'm one of the guys that had a very painful biopsy.
I was also told afterwards that it is not possible to give anaesthetic for a biopsy!!!!
After a ten minute rest I was however able to walk home (about a mile)
I took some Paracetamol/Tylenol immediately I was home and over the next couple of days and basically had no pain after the biopsy. I had to lie down for an hour or so the afternoon after the biopsy, but that was perhaps more cos I had been a bit freaked out than anything else.

Tiny bit of blood in one BM.
A few bits of blood in urine for first 24 hours after biopsy.
Blood in semen was not pleasant to see, that lasted about 6 weeks through various shades of red brown and black (use a condom)

You should also be given antibiotics to prevent an infection. To be most effective you should be told to start taking the antibiotics the day before the biopsy.

Ask for pain relief is my big suggestion.
Also the results are what counts.

Alf
Posted 11/8/2010 8:59 AM (GMT -5)
This has been an interesting thread. Obviously, for some guys (my older brother is a perfect example), the biopsy is a torturous experience, while for others (as in my case), there's little if any pain involved. I don't think we've reached any consensus regarding the reasons for such completely different eperiences. My urologist told me he started using his current procedure about five years ago, and that there's no reason the biopsy should be painful in the year 2010.....uncomfortable, but not painful.

So, I'm still wondering if the different levels of pain can be best be explained by anatomical differences (location of nerves, condition of hte prostate, and so forth), or whether the skill of the urologist and his appropriate use of various anesthetics is the determining factor. I'm inclined to believe the latter. And, if that's true, those urologists who continue to inflict high levels of pain should be ashamed of themselves.

I know we all have varying levels of pain tolerance, but the descriptions given in this thread can't be explained away by pain tolerance.

In my case, I was on my left side, in a sort of fetal position. Topical anestetic was applied inside the rectum, and then, as I recall, two injections of additional anesthetic were given inside the rectum. The doc left the room for about five minutes to give the drugs time to take effect. After that, no pain, and barely a sting with the injections.

Just as some dentists are better at "painless dentistry," I'm thinking some urologists obviously do a better job at minimizing pain during the biopsy. I think a frank discussion with the urologist prior to the biopsy would include the question, "What do you do to minimize or eliminate pain during the biopsy?" If the uro can't assure the patient that there will be minimal or very minor pain, I'd find a different doc.
Posted 11/8/2010 9:07 AM (GMT -5)
This is one of several threads we have had over the past couple of years on the subject of biopsy pain.  The responses have been uniform in their lack of uniformity...i.e. the pain experience is all over the map with some posters indicating "no big deal" and others indicating "excruciating".

For me it was in the "no big deal" category because my doc uses IV anesthesia during the process.  His standard is 16 cores and his philosophy re the anesthesia is that (a) there is no reason to have his patients experience pain and (b) he wants to take his time and do it right without a squirming patient on the table.  This makes sense to me.

Tudpock (Jim)

 

Posted 11/8/2010 9:43 AM (GMT -5)
All I know is that I'm voting for the no pain concept. I can deal with uncomfortable but pain and I don't mix. I'm 48 hours away so I'll report soon soon after the procedure. And yes I was given 6 Cipro tablets and instructed to take one in the morning before the biopsy and then 2 per day for the next two days. And I will have been introduced to the pleasure of Ducolax suppositories (one the night before and one an hour prior to the biopsy).

Now the real question arises.....how long can one feasibly milk the "horrors" of this procedure with one's wife? I'm thinking at least a month of not helping around the house and being waited on would be in order. tongue
Posted 11/8/2010 10:39 AM (GMT -5)

rgmjr said...
Now the real question arises.....how long can one feasibly milk the "horrors" of this procedure with one's wife? I'm thinking at least a month of not helping around the house and being waited on would be in order. tongue

You can proably get some mileage out of having bloody semen.  It freaked me out and I was sort of expecting it.  Seriously, I hope you do not need to classify your experience as a "horror."  From my own experience, and what others have posted, wives are generally very supportive.
Posted 11/9/2010 11:06 AM (GMT -5)
as you can tell, the experiences vary all over the place...for me, there WAS (quick) pain, having to do with the placement of the ultrasound probe, but then it was gone and no big deal....one quick side note: i soon realized that a spring-loaded stapler that we use here at work makes, what i thought , anyway, exactly the same sound as the sample extractor gun...it took me WEEKS to quit clinching up everytime i heard the secretary use the stapler....but that reaction, too, passes with time...

yeah, don't forget to take the antibiotics they give you before the procedure, 'cuz if you do,  i'll bet they'll send you home and reschedule...

anyway, no big deal on the procedure...

take care

bob

Posted 11/9/2010 10:03 PM (GMT -5)

My biopsy (12 cores) was not painful, but somewhat uncomfortable.  The worst part was the anticipation anxiety.  Once the 2nd sample was taken, I was relatively relaxed through the rest.  I did not experience pain afterwards and didn't need to take any meds for it.

Posted 11/10/2010 11:11 AM (GMT -5)
Thanks guys. I just took my first Cipro and about to take the Lorazepam and head to the biopsy. I'll report my opinion afterwards. I think I know exactly how a condemned person on death row is as he is walked to the death chamber cry

Anyway as everyone has said, the anticipation is the worst.
Posted 11/10/2010 11:16 AM (GMT -5)
By the time you read this, you'll probably be home from the procedure. I hope it went well and that you're relaxing at home and getting ready to post a comment about how uneventful (and hopefully painless) it was.
Posted 11/10/2010 11:43 AM (GMT -5)
If you want to see how they do it in Australia, check out the "GP perspective" thread..

On second thought, maybe you better not go there...
Posted 11/10/2010 4:44 PM (GMT -5)
Well guys I finished and home. I must say that the aniexty was the worse part . I think I felt the initial numbing injection but can't promise it was that. The whole thing was performed by one doctor and one nurse and honestlythe taking of the biopsies was just about 100% painless. It was over in 10 minutes. They had given me 49mg of Lorizapem which is still making me groggy and i'm walking like a drunk - and my typing is suffering a bit.

As for obout,3 hours post prodecude I feel a bit uncomfortable amd still very fuzzy inthe head but that's about the worse of itl. I am difinitely peeing blood but am having very litte pain and discomfort. so put me down as oe who feels can state his bisopy was pretty much a breeze. now back to bed. Sorru for allthe typos bt we can blame the drugs.

I'llsend more later.
Posted 11/10/2010 4:46 PM (GMT -5)
Glad to read that all went ok with your biopsy. All the best on the results!

Tim
Posted 11/10/2010 10:27 PM (GMT -5)
Understand the anxiety - underwent 12 stick biopsy - family doc prescribed 1 Lortab and 1 - 5mg valium to be taken shortly before procedure. Urologist administered deadening shots to prostate which were not really painful, waited a few minutes, and then began the biopsy. The entire process was over quickly and again, the sticks were not what I would call painful. The worst part of the procedure was the very thorough DRE that came before the biopsy. My wife drove me home and we attended a 3 hour event that evening at which I was sitting the entire time without much, if any, discomfort. I experienced very little soreness the next day. I know the biopsy experience is different for everyone, but it was not nearly what I had dreaded. I do think the pre-meds helped a great deal. Good luck.
Posted 11/11/2010 12:13 AM (GMT -5)
rgmjr,

Glad it went well for you. Hope the results are manageable.

Wish I'd had more drugs before my biopsy. But, that was the only prostate biopsy I'll ever have.

DJ
Posted 5/20/2011 7:51 PM (GMT -5)
I had a prostate biopsy today. It is my first. It was uncomfortable, but not painful.
The one I had used an ultra sound device shaped like a very large finger. Thankfully, it was inserted only 2-3", still that was uncomfortable. To get a looksy at various locations of the gland, the doctor moves the device around some and uses significant pressure time to time on various locations of the sphincter/colon. So, that was uncomfortable. He administered a local anesthetic with a hypodermic syringe/needle, and that was a little uncomfortable. He used a "snapping" (my word) type sample gatherer that feels like someone is snapping a rubber band around that area, which felt less uncomfortable than the moving and pressing ultra sound device. From start to finish, it took <20 minutes. My friend drove me home shortly afterwards.
There are other unpleasant experiences involved: Prep includes a Fleet enema two hours before the procedure.
Post procedure: It has been 5:30 hours since the biopsy was finished and I don't feel good: The perineum area hurts and I feel like I'm coming down with the flu. I'm going to have some soup and lie down and read in bed (it is 5:45pm now.) Urination is difficult, probably because the prostate gland is swollen. There is blood in my stool, but not in my urine.
I do not feel like I am going to die, just real crummy.
Posted 5/20/2011 8:49 PM (GMT -5)
PITA

I have had worse. As procedures go it was nothing. Recently I had an injection in my eyeball. The biopsy doesn't even register.
Posted 5/20/2011 10:32 PM (GMT -5)
The aftereffects of a biopsy can be pretty unpleasant..The blood in the urine will pass quickly, but in your ejaculation, not so fast.. You might want to purge yourself a couple of times first..Give it a few days before you do that..
Posted 5/20/2011 10:56 PM (GMT -5)
I've had 4 biopsies. Three normal 12 core and one 45 core 3D saturation. The latter you need to be sedated for. But the normal biopsies were just more uncomfortable than anything else. They were all over in 10+ minutes and I felt fine soon after for all of two of which I played golf the following day.

While not fun don't worry about it. Most men afterward find them to be anticlimatic, and all the fear not warranted.
Posted 5/22/2011 12:56 PM (GMT -5)
I am in the minority here when it comes to pain from prostate biopsy. I thought it was horrible. I tensed up so much from the procedure that my back hurt for three days. My urologist was an ----ole about the whole thing, he said it would be no big deal. When I had my second biopsy I got smart, I took my sleeping pill (ativan) a half hour before the procedure, much better, I didn't care what they did then.........

Posted 5/22/2011 9:40 PM (GMT -5)
rgmjr:

Just another opinion: It is uncomfortable and unpleasant - but not the worst thing I've had done. I did mine right in the clinic with a urologist that I liked a lot. He was very good. I only had a numbing agent on the end of the wand that went up my rear. He kept telling me to breathe as he seemingly drove all over the place (I'm sure he was just moving micromillimeters but it felt like he was driving around with a baseball bat), and he would say, "1 -2 -3" and pull the trigger. I found that very helpful. He did a few like that, then did one without and I asked him to go immediately back to the 1-2-3.

He took 12 cores and afterwards I was sore for several days (I did NOT feel like golfing). Yeah, there's a little bleeding, and you feel a little uncomfortable, but within a week I think I was pretty much back to normal.

I was also told that I had an 80% chance of having a negative biopsy. Incredibly I could not win with those odds, but you probably can!!

Good luck. I wish you all the best -
kcragman
Posted 8/2/2011 9:01 PM (GMT -5)
cool  

Either it's me or my newly found urologist.

We don't know yet if this will have real happy ending.  Same time next week.

This morning I had the Prostate Biopsy -- 10am eastern.

Prelims ordered were Cipro starting last evening, so I have now done #3.  A Percoset an hour prior, and Fleets last evening and just before leaving the house this morning.

I read their papers, and a bit more on the web, and fortunately not this forum.

So, I was put into a left side, knees toward chest position.

Doc did the digital exam first - no change from a month ago - about double normal size - at age 67.   Oh -- PSA was 8.6 several weeks ago.  about a double from late 2009 or early 2010. 

So far so good.  Just love that digit.  Then, they showed me the rectal probe and started to probe.  Ok, next step is a couple of shots of novocaine into the prostate.  Slight sting and irritation, but far less than the dentist shots.

Then an audio demo of the biopsy tool.  First shot/scrape - whatever, was a bit of a surprise.  Like a moderate blow to the gems.  Of course, I lurched a bit.  Doc suggested more novocaine, but also said that it probably was still taking.

Next several were quite bearable.  Then he said that takes care of the first six.  Oh well, I'm still quite OK.  Then we had the next six.  Number 11 was a bit tough, and then it was over.

Cleaned up... a bit of blood on the Kleenex, and dressed, and out the door within about 50 minutes from arrival time.

No pain since.  I urinated right after, and a couple of the ones in early afternoon had a bit of pinking in the start, but then normal.

One attempted BM since, but just lots of gas, and I'm a once a day in the AM man, so I'm not concerned.

Hopefully, there will be good news next week.  The Doc said mine is round with no nodes.

Just wanted to add my notes of rather ease - so far.   I'm retired, and have been puttering around all day, with a bit of gardening and clearup.  Just as well could have gone to work by noon if I had to.

Guys, don't complain to your partner.  They bear a lot worse between cramps, labor pains, breast compression on their exams, etc.  

Good luck to any future readers.

 

Posted 8/3/2011 12:34 AM (GMT -5)
I had a 16 core biopsy done last week. I had it done under general anaesthetic as I had a cystoscopy done at the same time. Blood in urine the first time only, then no problems at all. Ofcourse, I didn't feel anything during the actual procedure but I didn't have any discomfort afterwards either.

Got my biopsy results yesterday, all 16 cores -ve, so far so good. I'm no worrier but I found waiting for those biopsy results to be one of the most unpleasant few days I've ever experienced. The not knowing is most definitely the worst.
Posted 8/26/2011 8:39 AM (GMT -5)
 

nodiet4me
 

I would like to welcome you to our little club where a bunch of good guys and even some concerned wives, girlfriends and daughters share their experiences about their personal or loved one's journey down the PC path and can answer a lot of questions and provide good free advice. I unfortunately did not find this club until a month after my prostate surgery. Having said this, we hope to never hear from you again, because that means your biopsy will come back negative for PCa. If that is not the case then we welcome you to come back as much as you need.

I can still remember my biopsy last April and the 2 nights I spent in the hospital with a blood infection afterwards.  The biopsy was a piece of cake, but  the blood infection was rather scary. This was the first time I had been in a hospital since I was 8 years old, little did I know that it would not be my last.

Good luck on your results as I know the next week will be full of worry and wondering but again we all are pulling for a big negative result for you. In the meantime if you have any questions please start a new thread and give all of us a better chance to get to know you and your particular situation.

The Water Guy

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