Prostate Biopsy

I have a question about prostate biopsies. My husband is having this done in a few days and I would like to know what to expect during and after the procedure. I am disabled and not able to go with him, our daughter is going.

He's 77 years old and it's the rectal type of procedure. Is it safe? He previously has had enlargement but now it's down to a normal size. The urlogist felt a small hard area on one side and thought a biopsy to be in order. Thank you for any information from those who have been through this.

I've read that sometimes this is postponed. I don't understand what that's all about.

Post Edited (memaw12) : 6/4/2017 10:11:46 PM (GMT-6)

Thank you George.

I think my biopsy was outside the usual experience; but it was awful.

First, I picked a new and young urologist at Emory to do it, as the other doctors would require a 3-month wait.

He actually had to call another urologist in during the biopsy. I had a lot of pain afterward and three doctors gave me meds for hemorrhoids. After 8 months or so, I finally went to a gastro specialist and he said I had a fissure. It was worse than any of the cancer treatment. I had to leave work a few times because of it.

So, I'd make sure he gets an experienced doctor and plenty of lube. I'm good now, but it took a year to get over it and it was a real pain in the behind, literally!

Some guys have no issues but I had an experience very similar to lapilot. I asked for something at the pre-procedure visit to help with the pain and all they would do for me was a Valium. Totally useless. I should have insisted on Demeral or whatever they use for a colonscopy. Hurt like hell after the 3rd punch.

The AUA and now the USPSTF recommend no PSA tests (and therefore no biopsies) after 70. ACS pushes the limit to 75. It depends on his physiological age and not just his chronological age. It also depends on whether he would get treatment if it is positive. You can use the following nomogram to see what the odds are that prostate cancer would kill him if left entirely untreated for the next 15 years:

/webcore.mskcc.org/survey/surveyform.aspx?&preview=true&excelsurveylistid=4

He should ask that his biopsy be performed using either a "periprostatic nerve block" or a "pelvic plexus nerve block." He should ask for them by name.

He should also tell his doctor about his history of antibiotic use. Resistant infections are on the rise. Swabbing the area with povidone iodine is probably a wise precaution.

They stick an ultrasound probe up his butt and use it to guide the biopsy corer. It's the size of an 18 guage needle. They usually take 12 cores.

There may be a little rectal bleeding where they poked the corer. Because a bunch of little blood vessels were pierced by it, there may be some blood in the urine for a few days, and blood in the semen for a few weeks - bright red, eventually turning brown as it dries up. It looks worse than it is.

If he starts running a fever call his doctor immediately or go the the ER.

MDNative, The reason for the biopsy is that the doctor felt a hardened area on one side of the prostate.

For me the biopsy was amazingly easy. I took the anti-biotic earlier in the day. Then I went to the doctor's office and he administered a pain killer (I don't know which one), and began the procedure, with me laying on my side. He took ten samples. Each time it felt like something going SNAP inside me, but it didn't really hurt. It was a somewhat unpleasant experience, but not horrible. I was glad when he decided to take only ten rather than twelve samples. Then he pulled the device out, and it was over. He warned me about blood in urine or ejaculate, but I had none. No residual pain or discomfort, and no infection.

hello Memaw12 ....my experience with the biopsy was exactly like fiddlecanoe`s.........the biopsy was over in 5-8 minutes.....a couple shots in the butt as I remember .....the snapping SOUND was more of the issue for me than any real pain .....once the first few samples were "snapped" ...the rest was all down hill......very easy thing to go through and the peace of mind of knowing what`s up , is well worth the short unpleasant ordeal.....good luck ....just do it ......David

Love is the best medicine.

The blessing of this procedure is its brevity. I took a lot of comfort from holding my wife's hand. Deep breathing and willful relaxation of all of his muscles will help.

My urologist is old school about pain. He didn't offer anesthetic (I wish he had), just a Valium 5 minutes before the procedure. That would have kicked in during my ride home.

I had no bleeding, but I had severe pain a couple of nights post-procedure that responded immediately to a short course of oral antibiotics.

Depression and anxiety are natural responses to cancer fears. Patients don't have to tough this out. A mental health professional, in your case one who specializes in older patients, can be invaluable, even if it's only needed for a short time.

My personal experience is prostate biopsy was not very painful, I could drove one hour home by myself without feeling any pain. But everyone is different, also depending on the urologist skills. I remembered I heard my urologist talked to his resident doctor during the procedure, "don't collect from that area, it will be painful for the patient". There were 2% chance the patient will get infection from biopsy, I was one of unlucky ones. Some articles said it was more like 6.7% chance. The antibiotics I took one day before the biopsy could not kill the E Coli I have in my rectum. I was hospitalized for 4 days. Not a good experience.
Anyway, the biopsy is not a risk-free procedure. Take the right antibiotics, watch out for any chill feeling, shaky hands, and check temp for fever after biopsy. Good luck to you.