Deeper sedation during biopsy

I've been scheduled for my first biopsy in a few weeks. I'm 51 and my PSA was 5.5 recently, and I have some BPH symptoms but nothing showing from a DRE. I am extremely doctor-phobic, and just reading about the biopsy procedure on the web caused me to vomit and hyperventilate.

My doctor, who has only spent about 10 minutes with me, seems to think a local will be just fine. Based on recent arthroscopic knee surgery, I know I'll need at least two snorts of Versed to calm down and stop hyperventiliating. I told him this and he was unconcerned, and just prescribed some oral valium.

Is this procedure commonly performed under deeper sedation than just a couple of valium? It is worth shopping around for a different urologist at this stage? I'm worried I'm going to have a heart attack just thinking about it. Maybe I should start hoarding the valium now!

Post Edited (firsttimer) : 11/5/2007 4:08:11 PM (GMT-7)

Hi firstimer, I am in a different country, but when I had my biopsy, I had a local cream applied to the area by a nurse, and then was given a intravenous sedative....did not feel a thing! If I was you I would request a sedative or find a doctor that will sedate you...it's YOUR body my friend!

Regards Mal.

Firsttimer-

When my first urologist/quack proposed a biopsy and I was concerned, his reply was "it's no big deal". I then asked him if he's ever undergone one, and his answer was "no". I didn't realize he was a quack at the time and I let him do the procedure. He injected some lidocaine first, but obviously didn't wait long enough for it to start acting. The first six "punches" were excruciating. By that time the lidocaine must have kicked in, because I barely felt the rest.

Just by the fact that this guy has spent a total of 10 minutes with you, and is not concerned about your concerns, leads me to say - find another doctor. You're in charge of this ship, not them.

-Les

I am alway surprised when a urologist does a biopsy without first making his patient as comfortable as possible.  As I have stated here before I had a full IV valium which put me comfortably to sleep.  I had a guided biopsy that I never felt.  I had some minor bleeding after, but no pain. Any doctor who does other than this is , In my opinion, not practicing good medicine.

You decide.  If your doctor does not agree.  Get another doctor.

o.k. sterd...LOL
I only needed the local. No orals, no problems, and no trucks...

hi Firstimer

Sorry but I couldn't resist responding my buddy sterd82.  Take it easy on this.  I wasn't a doctor friendly person, but they are my best friends now.  I hope you get through the biopsy ok.  And by that by that I mean kickin' and screamin' will do instead of a positive test.  My experience was wierd but normal.  I did have a day or so of discomfort.  And I did have some blood in ejaculations.  But I had to do it and it wasn't too bad.

Tony

Hi Firsttimer

I had a 29-core biopsy on September 27, 2006! I must confess that there was not much discomfort. A sedative was injected into my prostate (a little pin prick through my rectal wall into the prostate—then you could feel the sensation of the serum being injected). Then it was 29 clicks and we were done. I did feel one big pinch perhaps before the sedative took hold. So don’t be fearful of a biopsy—make sure that your urologist performing the procedure gives you some kind of sedation in your prostate beforehand. I was surprised at the number of samples taken, but it gives me greater assurance of my stage of cancer. If you have a biopsy, don’t settle for less than 12 samples; a minimum of 20 would be preferable. Having too few biopsy samples may not give you the best indication of your stage of prostate cancer which is critically important in selecting your treatment.

If your urologist gives you adequate sedative in your prostate you should be fine.  That's why it is so important to question your urologist beforehand as to the exact procedures he will follow and what you should expect.  Adding a valium should relax you overall.  You are very normal to feel some anxiety before this procedure.  I put off my biopsy for far too long becaue I didn't like the thought of having someone snip off pieces of my prostate.  It was only when my PSA got too high that I was quickly motivated to get the biopsy done.  I will never know if I lessened my chance for eradicating my PCa by waiting longer than I should have to determine if I had PCa and start treatment.  Live and learn.  Good luck to you!

Dave

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I know how you feel. I had my Dr put me out before the procedure as I am a chicken as well. He told me that I was the first that he had " put under". Remember that it is your body and you have hired him to do whatever. People have a tendency to do what ever the Dr wants with questioning them

Hi;

My first biopsy was very painful, and came out negative, but I believe because the Doctor did not take enough samples because he knew I was in pain. A few years later my PSA jumped and the same urologist said I needed to have another biopsy. My answer was that I would do it under sedation only. He refused so I switched to another that would. The second biopsy showed malignant cells and a Gleason 7 (3+4).