How many have had biopsy while being put to sleep ?

Buddy of mine has rising PSA 50 yrs old 2.5 now 3.5 Dr wants to have biopsy, he doesn't want it because his Dad had one and said it was painfull. Cant he just ask the Dr to do it under anistesia ?

My Uro said he had done a few that way when the guys had to tight of an opening ????

He is stressing big time ( as I probably would be too, check that I KNOW I would be too ) Should he find a Uro that will do it while under ??  Seems like they should do it taht way in a case like this or any case for that matter...

I hate to say but my biopsy experience was not good. I was taken from the DRE straight into the biopsy room, I got no medication at all, other than a shot for infection. Be sure you ask to have some type of antistesia.

I had a local anesthetic, which was allowed a few minutes to take effect before my biopsy.  The anticipation, particularly before the first biopsy sample, was the worst part of it.  For me, it was uncomfortable but not painful.  

...don't remember a thing about my biopsy. Uro put me in a state of "twilight"....just enough, when he was finished i didn't have to go through any kind of recovery, actually I can remember being taken out of the room and him talking to me before I left the hospital. As far as I'm concerned....that's the only way, it is the 21st century and if we don't have to experience pain or being uncomfortable, no need to....same game as Billy explains, in and out and i dont know!

    Have him ask the doc about it..

I was really chicken about my biopsy and asked my doc to put me under -- he said he couldn't do that in his office, but he gave a a script for a single valium to take an hour before.  I told him I was REALLY chicken, so he added a second script of, I think, seconal (or something like that).... I was higher than a kite for the biopsy, but just fine an hour later.   Didn't mind it a bit!

Had three biopsies. The first two were conducted in doc's office...no anesthesia...nothing. Hated every minute. Third exam, still in doc's office, but I took valium ahead of time. The doc inserted probe and anesthetized the prostate, and then proceeded. I kept thinking i was feeling pain, but i realized eventually that i was only feeling a bit of uncomfortable pressure. The loud snapping of the clipping arm freaked me out. But my doc's warped sense of humor made me concentrate on something else. Deep breathing was important and also remember not to tighten up. The test took only 20 minutes if that long.

My advice: tell your buddy to do what his gut says to do. If he needs anesthesia to soothe his nerves, find somebody that will do this.

I think getting a root canal is worse then a biopsy   (mainly cause a root canal takes a lot longer)

The fear of a normal 10+ core biopsy is much worse than the biopsy. It's not pleasant but it's more uncomfortable that anything else. As far as an above poster wrote I never had blood in the stool or urine afterward. Although you will for awhile after in your ejaculant. Now my 45 core saturation biopsy was one you needed to be knocked out for.

Rocket1952

You bring up an interesting point.  My comment above was probably a bit over the top, however one of the things we learn here is that we need to take responsibility for our own treatment.  I have a great urologist, but I first had an appointment with a doctor who is in the same practice as my doctor (but at a different location).  I was not happy with him and did not like his approach.  I decided to go to a different urologist,  it was the right decision.

So, How do you do that?  You are in an area with many well known prostate cancer specialists.  Ask some more questions here, do some research, and then quietly make an appointment with a doctor that you feel can help you. Go talk to him, you will be able to tell the difference.  I don't know of any doctors that refuse antibiotics and refuse anesthesia. I don't know your particular situation but That just doesn't make sense.

I am sure that you will get some great responses from people on this site.  These are people who know doctors in your part of the country.  Keep in touch and let us know how things are going.

Sorry I don't know any urologists in Boston.

My biopsy was done in the urologist's office with antibiotics given a couple days before the procedure and an antibiotic injection imeediately prior to the procedure. No sedation. I found the procedure very uncomfortable but not painful, if that makes any sense. I am an anesthesiologist and have seen the procedure done with heavy sedation; for your urologist to do that he's need to schedule it at some location that has anesthesia providers; an intermediate course would be for the urologist to administer a light sedative himself; it would be unusual to be "put to sleep" in the sense of a general anesthetic, although in one sense the difference is not one that the patient appreciates--general anesthesia or deep sedation both result in not being aware of the procedure. I questioned my urologist about his method and he said he believes there is less bleeding during the procedure if you don't use heavy sedation. There is also obviously both a financial and a efficiency payoff for the urologist to do the procedure in his own office.

Good luck with your procedure--hope the results are negative!
Paul

Dear Rocket:

Further to my previous post, I DID find a urologist who did the biopsy under anesthsia.  In fact, one of the reasons I changed from my orignial urologist was his insistence that it be done in his office with no anesthesia.

I don't know docs in Boston as I am in the DC area.  I found my new urologist by asking a friend who was a hospital administrator PLUS seeing that the uro was listed in "Best Docs in DC" as published by a local magazine  --  the criteria being who physicians would want to see for certain ailments.  There may be a similar publication in Boston.

Also, a ton of info about a practice can be determined from their web site or a phone call.  For example, my new urologist had short articles about procedures published on the web site.  In the article about biopsies, it was clear he used anesthesia. 

This whole deal is stressful enough, why bother with unnecessary pain/discomfort?

And, as long as you are getting a new urologist, you might as well make sure they are experienced in a procedure.  Chances are that anyone who has PCa now will at least consider robotic surgery.  So, why not check for an experienced (200+ procedures) robotic surgeon for your next appointment? That way you won't have to change again if you end up wanting surgery and your "new" urologist is not experienced...

Paul in Pa said...
Sorry I don't know any urologists in Boston.

My biopsy was done in the urologist's office with antibiotics given a couple days before the procedure and an antibiotic injection imeediately prior to the procedure. No sedation. I found the procedure very uncomfortable but not painful, if that makes any sense. I am an anesthesiologist and have seen the procedure done with heavy sedation; for your urologist to do that he's need to schedule it at some location that has anesthesia providers; an intermediate course would be for the urologist to administer a light sedative himself; it would be unusual to be "put to sleep" in the sense of a general anesthetic, although in one sense the difference is not one that the patient appreciates--general anesthesia or deep sedation both result in not being aware of the procedure. I questioned my urologist about his method and he said he believes there is less bleeding during the procedure if you don't use heavy sedation. There is also obviously both a financial and a efficiency payoff for the urologist to do the procedure in his own office.

Good luck with your procedure--hope the results are negative!
Paul

Hi Dr Paul

Maybe you can explain what we are saying when we talk of a "light sleep" anesthesia.  This is administered by IV and (correct me if I'm wrong) doesn't require a anesthesiologist to administer.  The nurse or technician called it a valium-like light sleep.  That is what I refer to and have had for my biopsy and three colonoscopies.  My surgery anesthesia was different and required a medical doctor...like you to do the job. Thanks

lifeguyd,

We divide sedation into four arbitrary categories: light, moderate, deep and general anesthesia. It is really a continuum. For light sedation, a patient will report feeling more relaxed but there won't be too many other signs of effect of the medication on the patients breathing, blood pressure, responsiveness, or heart rate. For moderate sedation, you start to see a decrease in responsiveness but the breathing , blood pressure, and heart rate don't change much. For deep sedation you may need a painful stimulus (like pinching your shoulder) to get a patient to respond; his breathing may be compromised because of the tissues in his mouth and throat relaxing, and the drive to breath may be impaired; in general anesthesia the patient does not respond to painful stimuli, often the airway is obstructed and requires an breathing tube/device, breathing may need to be assisted because the drive and/or ability to breath is decreased or gone, and there may be depression of the blood pressure. It also gets trickier (ie less predictable responses, more rapid changes, more sensitivity to the medicines) if the patient has other medical problems, esp respiratory, cardiac, neurological problems or obesity.

The general principle is that if you administer sedation you should be able to take care of whatever problems are common to that level of sedation, plus one level deeper in case you over shoot. So practically that means most non anesthesiologists are comfortable giving lignt sedation; moderate sedation takes a little more training, and the last two levels require significant comfort with airway management. Some GI doctors who do alot of sedation will get the training or have someone with the training available to give moderate to deep sedation in their offices; where I work we (eg the anesthesia providers) give deep sedation to everyone getting colonoscopies. Sometimes physicians who want to do a lot of procedures in their offices will hire anesthesia people to administer sedation in their offices.

It's sort of confusing but I hope that helps a little.

Paul