PrecisionPoint TP Biopsy

It sounds like a transperineal template mapping biopsy. It is always done with a spinal block - you shouldn't feel a thing.

Ask for the drugs, spinal block, etc. No reason to have pain for a procedure. The first procedure you had should have included at least a local to dull the pain.

Just tell the doc that if pain management isn't part of the procedure you won't be there. The spinal block, sedation, sedatives, etc should be standard part of the process. If it's not, or they won't, you need a different medical team.

Keep us updated on your result.

Andrew

Biopsies seldom have sexual SEs - except for blood in semen.

I had my one and only biopsy a few months ago and it didn't hurt at all except 3 hours later, and that lasted for a only few hours or after I had a few jack and cokes to numb the pain. Pain is subjective I guess, also the uro doing the procedure is key I guess.
Good luck.

Thanks folks, it seems that PrecisionPoint is very new and hence it's early days, limited reviews etc. It is however what Hopkins is now doing; I also note that Fox Chase is offering the same.

It's being driven by their antibiotic stewardship programs, which is on balance a good thing.

Alas despite my loud but eloquent protestations to the senior clinicians at JHU they adamantly flat-out refuse anything other than local and an Ativan. Fox Chase interestingly offer same under GA but that adds a wrinkle to ones AS program status.

Hey Ho.

I had the TRUS biopsy performed in the uro's office with a peri-prostatic nerve block. Yes, a brief sting when the nerve block was injected, but after that - I only felt pressure, no pain.

A couple of months later, I had my fiducials (gold seed markers for radiation treatment targeting) implanted trans-perineally, with only a topical numbing gel and a Xanax for pain management. That procedure HURT, but it was only 3 sticks in a 5-10 minute period. No real discomfort afterward, though. I guess if they were going to do a biopsy without pain meds, I'd balk too.

Now, the trans-perineal biopsies, AFAIK, are always done with some very active pain management. Just too much poking going on in that procedure. Ask what they will use. If it doesn't meet your expectations, maybe some other doc should do the procedure. . .

So, I had the aforementioned PrecisionPoint trans-Perineal biopsy last Friday at Hopkins. I was terrified leading up having had a nasty TR previously so had 4mg of Ativan on board courtesy of the Prof. Not too much to report that I can remember thanks to that!

They need you to urinate afterwards before they'll let you go home - so arrive with a somewhat full bladder. Procedure is done on your back with your legs in stirrups - yup like a woman, no biggie. Ultrasound probe is still trans-rectal of course but a contraption strapped to the probe aligns the puncture needle axially to the probe (outside). This is then slid forward to pass through the perineum and into the prostate, thus providing a transit path for the dreaded 'clicky' biopsy needles. Presumably they make multiple punctures (at least internally) to array the cores around the prostate. Try as I might I can only see one puncture mark (and thumbnail sized bruise) on my beloved taint to the righthand side. They did 12-14 cores but I wasn't counting by that point (someone did hold fingers up for me with 3 to go though!). I did feel the sticks but no worse than a typical IM injection or blood draw. The Ativan meant I didn't care as I was too busy singing sea-shanties and trying to figure out why so many people were staring at me. There was a small crowd of onlookers it seemed (research hospital) and me 'being a hoot' by all accounts.

All ended within a few minutes and then they ask you to wee in a series of plastic cups - passed a couple of blood clots then all clear... you can go now sir, "who me"?

Somewhen after that I evidently got dressed and met my wife in the lobby, she duly latched me onto to an immoveable concrete pillar to stop me wandering and to keep me upright while she waited for paperwork. Half an hour later I was sleeping like a baby on our couch.

So...

I feel MUCH BETTER having not run the infection risk of TR (the whole reason Hopkins is switching over), no AB's required (not a bad thing). Pain level comparable - and with that Ativan on board I thought I was a tree anyway. Haven't tried sex yet, will expect blood of course but gonna give things a few days to settle down first. Wood seems good.

It annoys me that I had to virtually beg for $0.85 of Ativan to make this diagnostic procedure the largely non-event it was and should be. In fact at the 11th hour they did offer an OR based procedure with anesthesia... but given the experience above and my $0.85 investment I'd say it wasn't necessary (for me at least). Fox Chase DOES do anesthesia by default apparently.

Learnings to share: it's OK, no worse that TR, IMHO slightly better, lower risk of infection, better coverage of prostate (cores) no reason not to switch. I'm a lightweight yellow bellied chicken and $0.85 of Ativan worked out just fine i.e. no OR required.

Now comes the bad part... waiting on the results from Dr E.

Lotusman

Thanks for the update. I am also in the JH AS program, and Dr. Carter tells me that he wants one final biopsy before I “age out” at 75.

I have had five previously, with two causing inflammation and pain that lasted for six months.

I had not heard about a new type of biopsy, but I will ask if it applies to me, and if so, become more informed about it.

I also had the PPtransP biopsy. Thought it was very interesting and watched the procedure on the computer screen. The marvel of medicine. A robot taking samples directed by a computer image.

That's the kind of report you want to get!