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Posted 12/19/2012 4:07 PM (GMT 0)
I am going in today for ultrasound to get the prostate volume measured. Depending on the outcome I might need a biopsy soon.

After seeing some men stating that the biopsy is a very painful experience while other state it was so bad, I am wondering if conscious sedation might be the way to go, of would a local gel and injection suffice? The urologist offers the sedation option.

Any information is greatly appreciated!
Posted 12/19/2012 4:32 PM (GMT 0)
I had 3 biopsies in an 18 month period, while not a lot of fun, and somewhat humiliating, never felt the need to be "put under".

A handful of men here were put under, but that was their preference.

david
Posted 12/19/2012 4:37 PM (GMT 0)
It's hard to know how to answer the question since "conscious sedation" runs the gamut from a couple of Valium before the procedure to that stuff Marlon Perkins used to use on Wild Kingdom where he would shoot the dart into the charging rhino and it would take two steps an collapse in a heap and lie there twitching.

Personally I found biopsies mildly painful but incredibly annoying. I had my first w/o any sedation beyond the Lidocaine and I didn't like it at all. I had my next three on Valium and, to be honest, I didn't like them either but I hated them a lot less. I found that Valium helped me tolerate the procedure.
Posted 12/19/2012 4:46 PM (GMT 0)

lapilot said...
I am going in today for ultrasound to get the prostate volume measured. Depending on the outcome I might need a biopsy soon.

After seeing some men stating that the biopsy is a very painful experience while other state it was so bad, I am wondering if conscious sedation might be the way to go, of would a local gel and injection suffice? The urologist offers the sedation option.

Any information is greatly appreciated!

 lapilot,

All I can tell you is that my urologist put me under for my first and only biopsy, and I was glad he did. He told me that he routinely does it both ways, but that since I was a police officer, he didn't want my associates coming after him after it was done... :-)

Posted 12/19/2012 5:04 PM (GMT 0)
lapilot,
Welcome to HW! You will get a plethora of opinions on this topic. I had my biopsy done with nothing, not even lidocaine. It was certainly undignified but it was more discomfort than any significant pain. I have had more difficult dental appointments. Good luck.
SC
Posted 12/19/2012 5:07 PM (GMT 0)
The biopsy was annoying, embarrassing and undignified but not painful in anyway. I didn't feel the need for sedation.

You can ask for a pill if you want (sedative or anti-anxiety) if you want.

Andrew
Posted 12/19/2012 5:19 PM (GMT 0)
I just had one biopsy done prior to my diagnosis and had a local anesthetic only-so I was wide awake during the procedure. It was the only option that presented to me.

Some lidocaine gel on the probe which numbed my rectum a little bit, then the doctor gave me a few shots of the anesthetic into my rectum. It stung a little bit momentarily but wasn't bad. Sort of like having novacaine injected during a dentist visit.

The doctor then did the biopsy. Pretty much painless, but the snapping noise of the equipment was a little startling (but not painful).

My penis stung a little bit for a few hours after the procedure.

The benefits of just a local anesthetic are:

1) I could drive to and from the doctors office by myself.
2) I went back to work a few hours after the procedure.

My anxiety level going into the procedure was about a 9, but the actual pain/discomfort was about a 1.

I would compare the whole thing to getting a cavity filled at the dentist.

Good luck

Dan
Posted 12/19/2012 7:48 PM (GMT 0)
the worst part of the biopsy for me was the month of anxiety before the actual biopsy.  my doctor used some sedation and i was far from being under.  it was an unpleasant, uncomfortable experience but not painful.  that said, i would opt for sedation given the choice.

ed

 

Posted 12/19/2012 8:24 PM (GMT 0)
My OH never had any sedation but it was offered to him and in hindsight he said he wished he had taken the sedation. Each to their own but anything that can be done to make the procedure easier I would be all for it.

Posted 12/19/2012 9:13 PM (GMT 0)
My Doctor offered me a Valium, I declined but afterward I wish I had taken it.  Call me a wuss but if I had to do it again tomorrow I'd take whatever drugs he would give me.  Probably the most painful part is getting the local injection which in terms of pain is comparable to the shot you get when getting a cavity filled.  After that the biopsy itself I've heard described like someone thwacking you with a rubber band.  So the whole process is probably not something I'd describe as terribly painful but considering the location and everything else involved it was uncomfortable for sure.

ps: my doctor also told me the primary purpose of my visit was the ultrasound but when I got there the nurse said he always does the biopsy so that's what you should expect.   

pss: warn your wife ahead of time about the bloody ejaculate.   

Post Edited (Bob Fisherman) : 12/19/2012 2:16:54 PM (GMT-7)

Posted 12/19/2012 9:25 PM (GMT 0)
I think getting a root canal is worse. (mostly due to the fact it takes a lot longer)
Posted 12/19/2012 9:35 PM (GMT 0)
I have had three biopsy's.  The first nothing was given to me.  It was uncomfortable but not painful, maybe a 3 on a scale of 10.  The last two were done at a VA hospital.  The Dr. numbed the prostate first.  Felt a little sting for a few seconds then nothing.  It was over in a few minutes.  The worse part by far, was the anxiety before the procedure. 
Posted 12/19/2012 9:38 PM (GMT 0)
I did the sedation bit (like having a colonoscopy).

No problems.

Mel

Posted 12/19/2012 10:13 PM (GMT 0)
lapilot:

The actual biopsy doesn't take that long and isn't that painful, just some discomfort.  Some guys say it's a snap - you'll get my drift the day of the biopsy.   I don't like anyone fooling around with my rectum ( except one girlfriend I knew) , so I was very anxious about the procedure - the two of them I had done. I don't think IV sedation is necessary, but it's your call.   I took a 5mg Valium about 30 minutes prior AND make sure the Uro. waits a while for any topical anesthetic and lidocaine ( injection) to work.  And get a script for antibiotics to take several days after - I took cipro for 5 days.  Some Uro.'s prescribe Levaquin.

Good luck - Have fun, but not too much fun.
Posted 12/19/2012 11:05 PM (GMT 0)
Guys,

Thanks for all of the replies. Just got back from the urologist. My increasing PSA wasn't from enlarging of the prostate but from prostate stones, many of them.
Posted 12/20/2012 12:26 AM (GMT 0)

Each individual's experience varies.  My 12-core prostate biopsy was uncomfortable, but not painful.  The fact that the doc waited  a few minutes to allow the rectal lidocaine application to take effect made all the difference.  The anticipation anxiety was by far the worst part.  And I'm no John Wayne.

Posted 12/20/2012 2:09 AM (GMT 0)
I had only one biopsy without even local anesthesia or any pills. Before the biopsy I was terrified after reading many horror stories on internet. On the morning of the biopsy I nearly had an anxiety attack. But during the biopsy I did not feel any significant pain. I can tell you my pain threshold is very low.

Of course, that single biopsy led to a diagnosis of prostate cancer with Gleeson scale  3 + 3  and stage T1C.

Posted 12/20/2012 2:13 AM (GMT 0)
I didn't have any pain medicine and drove myself home after the biopsy. I was sore and it was difficult to sit for a few days. My procedure lasted less than 20 minutes. The doctor took 12 samples and it sounded like a pop gun after each pop. Good luck to you on whatever you decide.
Posted 12/20/2012 7:30 AM (GMT 0)
I wish I had been offered something for the pain (they said it wasn't possible to give me anything - unlike second uro who said they always give something!!)
So I suggest you have something just in case you are one of the people who will find it painful.
Alf
Posted 12/20/2012 1:21 PM (GMT 0)
I took a .5 MG xanax before leaving the house, and another one when i got to the Dr's office. I was wasted by the time it started, but had enough presence of mind to let the Uro know that i was 1. wasted and 2. terrified, and asked him to please use as much lidocaine as possible, and give it a few minutes to work.
There was no pain, just annoyance. The last one or two needles hurt just a bit but by that time i was much more relaxed and by the time i realized those two hurt a bit more, it was over and didnt matter.

Got home, no pain, no discomfort, a little bit of blood in urine, not dark at all, actually very little and only at the beginning of the stream, the first day or so. I did have blood in my semen for a week or so, then it just got to be a dirty looking color for another week or two.
The anxiety was much worse than the actual event. The most pain i had was when i had sex the next day, it burned. But only that one time.
Posted 12/20/2012 5:13 PM (GMT 0)
10 mg valium and a strong pain killer, prescribed by my Urologist. With that, I was fairly relaxed and had no pain, mild discomfort when the probe is inserted, but really no big deal at all, over in 10 minutes. I was also listening to music.

They injected some local pain killer that didn't hurt at all to start. I really expected the worst, it's more the thought of it(don't look at the instrument used) Again it was really nothing. I would never go it without the meds, no reason to. If your uro doesn't prescribe them, get another uro
Posted 12/20/2012 6:41 PM (GMT 0)
One more thing, while the biopsy was quick, painless and easy, I did have severe urinary retention the next day. If You already have flow issues, ask your doc for meds and advice on how to deal with that just in case. Mine said nothing and I almost went to the ER 4am next night
Posted 12/21/2012 12:28 PM (GMT 0)
I did the Valium before I got there, plus the lidocaine. The lidocaine injection was the only pain I felt during the procedure. However, despite preventative antibiotics, I still got a painful infection 2days after the procedure. I almost had to go to the ER to have a catheter put in. Fortunately, the second round of drugs did the trick before needing a catheter.
Good luck,
Paul
Posted 12/21/2012 12:55 PM (GMT 0)
LAPilot, Hi and Welcome. As you can see from all of the responses, it runs the gamot! For me, I took the "conscious sedation" route. Now I'm no wuss, played lots of competitive contact sports and suffered lots of broken bones, etc. - but, um, I'm sorry that particular part of my anatomy is different.

On another note, I would like to suggest that you look into "transperineal biopsy" - unlike the standard transrectal biopsy, this approach "allows better access to the anterior and apical aspects of the gland, in which clinically significant prostate cancer is often located."

Here's a couple of links, one that explains the process in lay-terms, the other is a published study report:

http://www.prostateimplant.com/STPB-stereotactic-biopsy.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834351/

Best of luck to you - we're all here to help.
Posted 12/21/2012 8:18 PM (GMT 0)
lapilot,

Put me in the discomfort but no pain category. Wasn't my favorite thing to do but not that big a deal either. I think I was helped by my uro telling me in detail what he was doing each step of the way and what to expect. Also, it does not take very long.

Do what makes you the most comfortable. Regards,

Joe
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