Prostate Biopsy: What To Expect

I just had my third prostate biopsy and it occurred to me that others waiting for this procedure might wonder what to expect. I had my first biopsy in 2000 and it was most unpleasant. I was referred to a urologist who performed this procedure in his office. At the time the thinking was that 7 samples were enough to determine the presence or absence of cancer. Today that number is 12. Well, the first experience was certainly kind of keystone cops affair. The doctor used a bit of lido cane on the prostate surface in an effort to reduce the discomfort/ That did not work very well.

Next he informed my the he was training his PA and would be using me as the experimental subject. If given the chance to refuse this honor my recommendation is that you do so; emphatically. The biopsy itself was quite painful under this condition.

The next time I had this procedure was Dec. 15, 2010 at the VA hospital in Salisbury, NC. Don't underestimate the VA, an overestimate is also recommended against. Anyway the primary interview went very well, with the procedure clearly explained and the necessity for it; my PSA is 10.9. Partial disrobing is required for access. The process begins with the patient reclining and the left side on an operating table; positioning for the doctor's convenience and patient comfort is paramount.

The first sensation is that of uncomfortable pressure as the lido cane is applied to the prostate. The next sensation is very uncomfortable as the additional injection of anesthetic is applied; sort of like a dental procedure at the other end. This without a doubt is the most discomfort one should experience. After a brief interval to allow the anesthetic to take effect the procedure begins. There is again pressure as the instruments are inserted. The only sensation then is the pressure of the punch which is extracting the tissue. The entire procedure takes about ten minutes.

Here your problems begin. You must successfully urinate to be released from medical care. The worry is that the bladder may spasm and/or blood clots will block the urethra preventing any urine flow. Most of the time this does not happen but should it then catherization is necessary to prevent injury and alleviate pressure. Once you return home plan on blood in your urine for at least three days; sometimes quite a lot of blood. If you are afflicted with hemorrhoids your recovery will be that much more uncomfortable and bloody.

There will be blood in your semen for a few weeks as well. Generally by week's end you will be feeling back to normal.

My third and latest biopsy was last week and was needed because the results of the previous one were inconclusive. "The cells aren't cancer but they are not normal" was how it was expressed to me. I waited six weeks to re submit to this invasion.

The latest exam was much worse than the previous and I can only conclude the one's choice of practitioner is paramount. This recent biopsy was marked by the haste of the physician as he did not wait for the anesthesia to take complete effect. The result was a great deal more discomfort and a longer recovery. Though I successfully urinated twice before leaving, lots of blood clots, apparently my bladder went into spasm. This meant a constant urge to urinate without success. Naturally I drank a lot of water to flush the system but the outcome was a swollen, full bladder and discomfort. I had been lying down, which I now advise against should this condition occur.

By coincidence I was seated at my desk in a bit of a cramped position discussing this with the VA urology nurse. He advise a return to the emergency room for a catherization flush. As the trip is an hour one way I decided to wait. Soon after my conversation I felt the urge again, most uncomfortable, and passed a series of large clots and urine. The deep red surprised me based on previous experience, but at least the worst was over.

I can only conclude that the doctor was determined to get larger samples to obviate the necessity of trying again so soon.

I am still waiting for the results which should come some time next week.