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Post Prostate Biopsy

User
Posted 18 Dec 2019 at 21:35

I had a biopsy last Thursday and have had blood on and off in urine and blood coloured semen ever since. I was concerned I had an infection which turned out to be correct so am now on day 4 of a course of 7 days antibiotics. The blood issue hasn't cleared and I don't know whether this is normal or not. Few questions:

1. Should I wait until I've finished the course of antibiotics before being concerned enough to call the doctor again?

2. The blood in my urine has been inconsistent since last Thursday, normally appearing for the first second when urinating then disappears. On the odd occasion the urine has been clear from the start which lead me to think that the tablets had kicked in and were doing their job but today the blood has returned. Any thoughts as to why this may be happening? Is it normal?

Thank you

 

User
Posted 19 Dec 2019 at 02:07
You don't say whether this was a TRUS biopsy or a Template one. An infection happens more often with the former as the needles traverse the rectum on the way to the Prostate. However, with a Template the cores are taken via the Perineum so less chance of infection but there are usually more needles so a greater chance of more bleeding. I had only the slightest indication of blood for about 3 days with my TRUS but rather more initially after the Template but this also cleared completely within about three days so I was quite lucky. Some men do bleed a lot more and for longer than others. Personally, I would not be concerned about some.blood in the urine just yet unless the problem doesn't improve. As regards infections, these can in some cases take a long time to clear up and for a small number off men need two or more courses of antibiotics, sometimes using different ones. If you suspect you still have an infection after completing your course of antibiotics, I would consult your GP. You want to get on top of this problem (if there is one) asap.
Barry
User
Posted 19 Dec 2019 at 08:53

Blood in urine and semen is perfectly normal. For semen, they say it can take 6 weeks to clear. After about 3-4 days, it will turn brown (like a scab does as it oxidises). My urologist said it's a good idea to ejaculate, and doing so daily, it took me 3 weeks to clear the blood.

Blood in first few cc's of urine is exactly what I had too, although for a shorter period. I also had occasional blood on stools (like perhaps once every 2 weeks) for about 3 months, but not immediately after the TRUS. (I got them to check it out at a subsequent template biopsy, and they said it was nothing to worry about.)

None of these are indicative of infection - they are expected.

Barry,
There's a third type of biopsy which is rapidly replacing TRUS, and that's exactly same as TRUS but done through perineum. It didn't have a consistent name for a year or so, but is now most commonly being referred to as LATP - Local Anesthetic Trans-Perineal. There's no template and typically 12 samples are taken, and this is done via two needle holes through perineum and pelvic floor muscle (one each side), and then guiding the needle by angling it into the desired areas, always guided by a previous mpMRI scan. It was made available by the development of a technique to administer local anesthetic to the required areas, so this can be done in an outpatient clinic setting, just like TRUS. Futhermore, it can sample the whole prostate, whereas TRUS can't sample the anterior, and is difficult to sample the apex. This work was paid for by PCUK and has now been taken up by a large number of hospitals, although Cambridge developed a similar procedure in parallel, but required a more expensive disposable local anesthetic scheme.

TRUS has a 3% rate of infection (which has been rising due to antibiotic resistance) and was regarded as unacceptable for a diagnotic procedure (particularly given some of these show up as sepsis and a few have been fatal). LATP has a 30 x lower infection risk.

Edited by member 19 Dec 2019 at 09:02  | Reason: Not specified

User
Posted 19 Dec 2019 at 08:58

Thank you so much for your reply Barry. Yes it was a TRUS biopsy. I will do as you say and keep an eye on it and let you know how I'm doing if things worsen

Thanks again

User
Posted 19 Dec 2019 at 09:02

Blood in the urine and semen is normal after a biopsy.  My own non-professional opinion would be to wait at least 2 weeks and if it isn't improving ask for advice.  Have you a named nurse or Macmillan Nurse.  Perhaps ring the nurse on PCUK if you're worried.  Although you could get another appointment with the result soon.

User
Posted 19 Dec 2019 at 09:04

Thanks Andy62, that has put my mind a little more at rest. It's very odd...this morning I had no blood in my urine. But later on today it may well come back, which is what has been happening. I shall ejaculate daily from today to try to clear blood from the semen.

Thanks again

User
Posted 19 Dec 2019 at 09:08

Thanks Peter, I've sent an email to a nurse on here. Am waiting to hear back. Thanks for putting my mind at rest. I'll monitor things for the next week as you suggest. I had the biopsy a week ago today.

Thanks again

User
Posted 19 Dec 2019 at 10:03

Quick question: Am I able to exercise normally now? It's been 1 week since the biopsy. I don't doing anything too excessive...15 min slowish run, press ups, sit ups, stretches squats. Thanks

User
Posted 19 Dec 2019 at 15:32
Yes, that shouldn't be a problem.

Best wishes,

Chris

 
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