Just how painful IS a transperineal biopsy?

My biopsy under local aesthetic was not painful nor any major issues afterwards.
Granted I have only ever had one, diagnosis and treatment followed.

(Laid back and thought of England !!)

P.

Edited by member 19 Jan 2022 at 20:19  | Reason: Not specified

I had a TPB way back in 2016 under a general anaesthetic and another last year, again under a general anaesthetic, and had no pain afterwards with either. Like others a little blood in my urine for a few days.

My biopsy was uncomfortable rather than painful, and far from the worse thing I've ever undergone.

I wasn't offered any anaesthetic.

I had 13 cores taken, 8 one side then 5 the other. i've since wondered if they stopped at that point because I was whinging, but suspect rather more likely was that it was because they'd biopsied all the areas indicated as suspect by the MRI.

I had one episode afterwards of blood in the urine, but it was a slight discolouration not bright red urine.

For me the procedure was far less of a problem than my imagination had built it up to be beforehand.

Thanks everyone, I appreciate the replies.

DaveHz - NO anaesthetic?! That sounds barbaric! (shocked face)

Yes, I imagine the thought of needles 'down there' is maybe worse than the procedure itself.

Seems to be a mix of local and general being used. Would still prefer a general!

Let's see what happens after the next blood test.

Stay strong folks.

Hi Brentmeister,

I had my Biopsy at the end of a very busy day, including a DRE, an MRI, the Biopsy and the issuing of Bicalutamide tablets as well as meetings with various consultants, doctors and nurses.

I do remember being given antibiotics for the biopsy, but I'm wondering now if someone slipped me a local anaesthetic somewhere along the way, but if so I genuinely don't remember it.

After reviewing everyone else posting having had local or general, and only me claiming no anaesthetic I'm starting to feel like an unreliable witness.

Edited by member 20 Jan 2022 at 20:30  | Reason: Not specified

I'm wondering if the higher core rate TP's use a general anaesthetic where the lower core rate samples might use a local.

If so, you would be better off with a higher core rate both because it will give a better sampling and possibly guarantee you a general anaesthetic.

Hard to know how these things work. It would be cheaper to not have to give a general anaesthetic though perhaps because of pain, it might not be possible to take a high core rate sampling with a local anaesthetic.

Any thoughts people?

Jules

Edited by member 21 Jan 2022 at 08:22  | Reason: Not specified

I had 20 cores taken under local anaesthetic. Half way through I did feel an uncomfortable scraping sensation when one core was taken but another shot of the local fixed it for the remainder. I did not pass any blood afterwards, but peeing wasn't fun for a while. Drove home after 30 minutes rest but sat in a soft chair for rest of the day. All that said, I would go for local again. 

I woke up on the recovery ward, all OK. My first two micturitions were like pissing razor blades, but no problems after that.

I discharged myself around 2pm that day, and had no further problems thereafter.

I did have a massive multi-coloured bruise on my perineum subsequently, and the inevitable blood clots in my urine and strawberry semen for a few weeks after.

So to answer your original question, the scale of my pain / discomfort after the surgery would be 3/10.

Best of luck.

Cheers, John.

It’s worth reading the conversations on here  about blood in the semen that occurs after biopsy, to prepare yourself. My doctor and nurses underplayed this bit. Totally normal and harmless but a bit of a shock if you’re not expecting it!

Hi Dave, the blood can be a bit surprising and a little unpredictable. I'm sure it will settle down and is almost certainly harmless.

Okay, I had mine yesterday and it was very painful.  The biopsy itself was not too bad (staple gun/quick punch).  It is the anaesthetic into the perineum and then the prostate that are very painful - but can be endured!  Nurse kept saying 'breathe deeply'.

Although the pain was intense at times I have had kidneys stones twice and they are excruciating!  I would have another under local anaesthetic if needed.

Lynn, it was a real shocker when I first ejaculated after the biopsy. Nobody prepared me for the colour, volume or consistency.

Grim, but normal and it does get back to normal. Just keep doing it, don’t refrain. 

I've had bladder, kidney and prostate procedures carried out using this method and no pain at all and zero recovery problems.

There may be a reason they don't offer it for those undergoing a TP biopsy but I would be interested to hear if anyone has had a TP done using this form of anaesthesia.

Thanks

That’s really interesting Lyn. I wonder if some of the medics had had it under local whether they would continue to do it. The nurses in the room looked a bit surprised that I was sweating and wincing so much!

But then I haven’t had much experience of procedures so maybe this is just one of those things you are expected to grin and bear? 

Nick, just to clarify - did you definitely have a template biopsy through the perineum (the area between your scrotum and your anus) and not a transrectal biopsy where they shove implements up your bum and take the biopsies via your rectum?

Had the local x3 which hurt the most followed with around 20 biopsies via the Perineum. Hated the sound of the tigger every time it was pulled, I was not given any antibiotics just verbal instructions which ended with the line go to A&E.
Walked out 30mins later after urinating no ill affects now just being informed by phone a appointment with the consultant has being made but refused to tell me the results not sure if they just want to prolong my agony. I just want my results to prepare my questions

Edited by member 28 Oct 2022 at 17:27  | Reason: Changed a few words

I realise this post is quite old now but my experience wasn’t good.

I-admit I was tense, okay scared a little and internally freaked out when my legs were taped into the stirrups!!

However it was painful the first few bits really really hurt and I blame the surgeon as as soon as the deeper two anaesthetics were put in and he got right on it.

the first several bites really really hurt. As the anaesthetic stared to work it got better

when I hot home I was very very sore and found it had to sit but the next day was a lot better

 ever again I hope !!

Although I don't doubt you had a very painful experience, I would hate anyone awaiting a biopsy not to have it for fear of it being painful as for the majority of us it's uncomfortable rather than painful. Like a PSA the biopsy is vital for getting the correct diagnosis.

I'm sorry for the pain you suffered an which you well in future treatment. Good luck.

Best wishes

Les

I had 4 biopsies, perhaps a Guinness record holder  :)

All were under local. Non of them painful but rather great discomfort. My first one was 5 years ago. When I recall it, I still remember that bad feeling for each of 8 sampling, I had an inner nervous shock even before the taking. However I learned that rather than concentrating on what is going to happen next, tried to keep my mind off the subject. By 4th biopsy (that was 24 takings), I mastered the art of not thinking about it, I got into a dialogue with one of the nurses in the room. It did work. I really did not notice much of anxiety, nor discomfort compared with 1st one. 

p.s

The 1st and 2nd (8 samplings) biopsy were 5 years ago while I was abroad. It had to be repeated as the first one was not conclusive, the net result was negative. 

The 3rd (12 sampling) biopsy 18 months ago came out all negative but MRI showed T3a. So it was again to be repeated as the result were contradictory. The 24 sampling showed G7 (3+4).

Edited by member 16 Mar 2023 at 16:28  | Reason: Not specified

I had my transperineal procedure on Monday with a local anaesthetic, and all went pretty smoothly. Beforehand, I’d watched a couple of videos on YouTube that showed the way it would be carried out in the UK and that was fairly reassuring. My main concerns were not so much about experiencing pain, but more psychological, especially the thought of needles going into an internal organ and getting embarrassed by presenting all my bits to a room full of medical personel.

The medical staff explained clearly what would happen every step of the way. I was given antibiotics and had to provide a urine sample which was probably the hardest thing I had to do. I had worried about the undignified position I’d be in for the procedure but in the event this wasn’t an issue as I was fully engaged in them getting me in the best place. The doctor repositioned my legs which pushed them as far apart as I was comfortable with and I had to shuffle down the couch to present the best possible surface. My genitals were scooped up in the gown and then taped out the way. 

After rubbing on iodine to cleanse the area, they first sprayed a freezing spray on the whole area which felt strange. I found the digital examination more painful than when my own doctor had done it, but the staff were very alert to any pain I was in. The two initial injections hurt as much as having one in your mouth at the dentists and I could feel the anaesthetic going in. The deeper injections that followed also gave me a small amount of pain but after that, the only thing I felt was the unusual sensation of the samples being taken.

I was played the sound of the biopsy capture to forewarn me and then the doctor began taking samples whilst one nurse engaged me in conversation to take my mind off what was happening. Afterwards, a dressing was sprayed on. I was given coffee and looked after until I felt ready to go home. They were keen for me to pass water which I did because I’d drunk loads beforehand to provide the urine sample. I followed their advice to take it easy for the rest of the day. There was a tiny bit of discomfort where the needles had gone in and a little bleeding. My urine didn’t have any blood in it but after two days, I ejaculated and that was a big shock. I was warned there might be blood in my semen, not that all it would like I was bleeding from my penis. Reading comments on here reassured me that this was perfectly normal.