First post looking for info

Hi All!!! Seems like a great bunch here. Can anyone recommend a very good urologist in the Austin, Round Rock, Georgetown Texas area. I'm in Georgetown and looking for a second opinion.

Do any urologist do a biopsy under sedation like with a colonoscopy? I've been told I need one and am really scared of needles up my butt.

How do I make sure the biopsy is read by the right person, lab?

I usually have a fairly strong stream but often stop then start up again a couple of times towards the end with necessary squeezing and using T. paper and more squeezing before I feel safe putting it back in. Dribbling problem. This has been going on for 20 years. But the last couple of years I have that got to go got to go right now.

about a year ago I started having orange color ejaculate intermittently. I read on various sites that it usually was not a problem and would usually go away which it would. Also read my taking warfarin causes blood in the semen. about two months ago semen turned bright red and now is that way almost all the time.

I am 63 My last PSA was .6 a year and a half ago. about six months ago my primary doctor said my prostate is smooth and small. I forgot to tell him about the blood probably because it wasn't occurring at that time.

I went to a urologist last week he said I had a bump or something on one side of my prostate drew blood for a PSA and told me I needed a biopsy. Results on the biopsy will be in Tue or Wed.

He answered my few unprepared questions but didn't offer much additional info, did not seem to be having his best day, was in a hurry, hurt me doing the exam. I don't feel confident that he will be gentle doing my biopsy and not sure I need one.

Appreciate any info especially blood in semen and a good caring urologist in my area. I'm really scared and have been spending all my time reading about PC. Thanks.

Hello Billhorn,

Welcome to the forum. Sorry you need to be here but glad you found us.

I've had four biopsies and, while I decidedly never learned to like them they weren't that bad. My doctor offers patients receiving biopsies a largish dose of Valium to take for the procedure. The biopsies aren't so much painful as aggravating and I found the tranquilizers mostly did away with the idea of switching places with the doctor to see how he liked the old staple gun up his rear.

There are doctors who will knock you out for a biopsy but I think a Marlin Perkins Mutual of Omaha Wild Kingdom Rhino-dart-sized dose of tranquilizers is enough.

Ask the uro who does the biopsy who he uses. He will use a kit provided by a lab. Mine was done by Bostwick, which is one of the best (my opinion, and many here might agree). If he says Billy Bob's Fast Lab in south Dallas, find another uro.

Thanks for the replies. Dr took a urine sample and said it was fine does that mean that there is no infection? I am not in any discomfort urinating of ejaculating.

Can anyone comment on chronic blood in semen relating to cancer?

Congrats Lotsa! My pathology was very good as well. I'm tortured with complete and demoralizing incontinence. 6 weeks post catheter now with no hope in sight. Any words of encouragement based on your recovery? SB

Hi Billhorn and welcome to HW. There are a number of threads about biopsies on our forum so you might want to use our search feature to check out the responses. In general I think most men find them uncomfortable but not overly painful. However that is not always the case and you might want to hear from the others also. There are a number of us who had biopsies under IV sedation so the procedure was much like a little nap but awakening to fell that someone has been messing around down there! No procedural pain however.

Unless your original biopsy slides are read by one of the acknowledged experts such as Bostwick or Epstein you will probably want to get a second opinion anyway.

I don't have any info re good urologists in your area but applaud your search to find one with whom you are comfortable and confident.

Just because the urine sample came back ok does not mean you are infection free. Some of these prostate infections are difficult to identify and many docs will advise a round of cipro or similar antibiotics prior to a biopsy. Also, you should get a free-PSA test and consider a PCA3 test www.pca3.org/public/pca3/pca3-background-information before your biopsy.

Good luck and please keep us up to date on your progress.

Jim

I second the comments that call for pain meds. I've had 3 biopsies and the first had no pain meds. I insisted on them afterwards and had many fewer problems. Sometimes there's a lot of blood and sometimes not. One thing I was not prepared for was blood in the urine and semen afterwards. It's normal for a while.

As for chronic blood in the urine, it's not something to mess with because it can be a sign of a serious problem. Blood isn't normal in urine. Sounds like they've already ruled out infection via a urine sample. I've had blood in the urine sporadically for about 15 months. The doctor sent me to a uro who performed a TURP and found prostate cancer. The prostate cancer had spread to the bladder. It's important to find the reason for the bleeding. The lump on the prostate is also not something to ignore.

I'm sorry you've landed here, but it's a good place to end up. Lots of support and information to be found.

Rich

I was like you and had it under IV sedation. I would recommend you do that.

I'd also recommend you first get a second opinion from another urologist, especially since you don't feel comfortable with your current one.

Yes, feeling something unusual during a DRE is cause for a biopsy. But, get a second opinion.

Mel

Thank all of you for the replies!

I have blood in my semen but no blood or anything problematic in my urine.

My PSA came back .5 but the urologist still wants to do the biopsy because he felt a node.

So I went to my primary MD for another check. I asked him if he had any reseverations disagreeing with another doctor. He said my only allegiance is to the you the patient. He then said he often feels the job of a primary physician is to prevent the specialists from killing the patients.

He says my prostrate is very small and the node is very small. He doubts that the node is causing my blood and mentioned warfarin can cause the blood.

I asked him if it were him would he have the biopsy he said no. I replied what about the cancer that PSA doesn't detect he said if you are worried about that then let him stick needles in you.

I then asked if he had ever had a prostate biopsy he said yes that he had prostate cancer and had his removed about five years ago. I asked if he had the robotic nerve sparing he said yes but that it didn't spare anything.

I'll get a second opinion from another urologist but am in no hurry. I'll try to find one that does the biopsy under IV sedation like a colonoscopy.

Any other thoughts opinions experiences advice will be greatly appreciated.

Would you have the biopsy?

I'm 28 miles from Austin TX. Thanks for the reply I'll go read about the PCA-3 test.

Wouldn't all those biopsy needle sticks do damage to such a small delicate organ?

Anyone know a place to get a biopsy under IV sedation in my area?

Hi Billhorn

Yes the needle sticks hurt a little, its more scary than anything. Its scary because of the vulnerable position you are in, the amount of discomfort and you know the peak of the discomfort is repeated 12 times. If you cant get it done sedated, then get some anti-anxiety meds to take so you are groggy/relaxed As Logo says its more of a mindf___ than anything. In any case, its over pretty quickly.

Good luck.

Welcome Billhorn
I have seen most of these guys post that biopsies were no big deal. For me, it was a quick procedure with a local anesthetic. I wish I had more for pain during the procedure. I have notes in my journal that described it as one of the most painful procedures I have had done. I felt all of the "staple gun" punches and could not believe the pain that was inflicted. That said, it was done quickly and I would do it again if I had to.

There is a saturation biopsy that goes through the perineum instead of the rectum. They definitely put you out for it. Not sure where you could get it done where you are. They do it all the time at the Chicago Prostate Center where I went.