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Just how painful IS a transperineal biopsy?

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User

Posted 10 Jul 2023 at 23:16

I had my Biopsy done back in October 2020 , very straight forward procedure was more uncomfortable rather than painful for me, a teeth cleaning sessIon at the dentist is more painful.

User

Posted 11 Jul 2023 at 01:41

It appears to me that it is the injections and time waited for these to take effect that may account for the widely differing experiences of men. Many will have had a tooth drilled and filled where the dentist waits a short time before drilling, while others let you wait in the waiting room while they work on somebody else and only then resume working on you - the latter with less painful results.

As previously mentioned, i can't say i found my 2 tp biopsies painful at all. However, I had to abort a Colonoscopy for a different problem as it was very painful, whilst others breezed through it.

Barry

User

Posted 11 Jul 2023 at 08:23

Barry - yes it is weird my guys did wait 5 mins by the clock between local injection and biopsy, but it didn't work well. The surgeon thought it might have been the fact that there was some inflammation in the prostate - but I don't buy that. I have had a colonoscopy and had no pain at all in fact I found it a very interesting experience. But they did give me an IV shot of something which was wonderful. In fact I wrote to the surgeon after to thank her and offered to have another one if she could give a a shot of the same stuff again!

User

Posted 11 Jul 2023 at 08:42

I agree that the time elapsed between injection of the anaesthetic and the procedure could be the cause of the variation in pain. Possibly as a result of inexperience (how many urologists have actually had a transperineal biopsy? They’d wait a bit longer if they’d had one themselves!) or of time pressure due to numbers - there’s a lot of us chaps just itching to get our feet in the stirrups.

My advice would be to ask to wait a bit longer for the anaesthetic to work properly.

User

Posted 11 Jul 2023 at 10:24

Nice recently issued guidance on TP biopsies. https://www.nice.org.uk/guidance/dg54

It is quite possible that your biopsy was done by someone with little experience in new techniques. On the guidance page you will see that you can make a yellow card report to report your experience. Things will only change if Nice knows there is a problem.

Dave

User

Posted 30 Jul 2023 at 20:59

Posting my experience as I hope it will help anyone about to go thru the same...

So I had a 24 core biopsy (this seems a lot - even my surgeon raised his eyebrows when he read my notes pre surgery 😳). It was done under a local anaesthetic. Medical team were excellent. Uncomfortable, yes but not really painful, anticipation of the next "click" was the worst thing. It sounds more like a stapler than a nail gun 😉. Afterwards a dull ache and just a feeling of tenderness. Bit shocked by the bloody wee afterwards and tbh I felt a bit dizzy so they kept me in for an hour for observation. Back home, quite sore for a bit but eased off after a few more hours and paracetamol. End of day, felt fine although soje sitting positions were slightly uncomfortable. I was mostly worried about after effects particularly infection or urine retention (as we were due to travel on holiday 10 days later). Little bit hard to wee for a few days, pinky brown semen for several weeks but pleased to report that ten days later I was laying on a beach (and trying to forget the fact that the biopsy results would be available on our return to the UK 😕)

User

Posted 30 Jul 2023 at 21:01

Originally Posted by: Online Community Member

I am sure there is a maximum number of cores that can be taken under a local anesthetic. I had 13 cores taken under my local and 19 under a general 3 months later

Ivan

Hmm, interesting. I had 24 under a local anaesthetic 😮

Edited by member 30 Jul 2023 at 21:02 | Reason: Not specified

User

Posted 30 Jul 2023 at 21:13

MIke had 22 cores taken under local anaesthetic

User

Posted 30 Jul 2023 at 21:38

I had 14 under local which subsequently broke into 21

User

Posted 30 Jul 2023 at 21:40

My husband had 26 samples under local. He said although he winced at every click, it wasn’t painful through most of it, at one point he started to feel more pain and they administered more anaesthetic and he was fine. Post TPB he was a bit uncomfortable but not really any pain and he was pleasantly surprised.

User

Posted 31 Jul 2023 at 04:33

I had 12 under local and 3 months later 24.

My 1st experience was rather teasing and uncomfortable. So I decided to keep myself busy (talking to the nurse standing next to me) 2nd time round. It did work. I virtually felt nothing during biopsy.

User

Posted 27 Nov 2023 at 17:30

Had a TB today

Feet up in stirrups with everything on show so forget about any dignity (doctor lifted scrotum and covered with a pad to keep it out of the way but not until both female nurses had had a good gawp at my meat and 2 veg)

Local anaesthetic, no more painful than the needle at the dentist

Mainly just uncomfortable but felt about 25% of samples taken, sharp stabbing pain and intake of breath, apology from doctor each time

2 nurses engaged in general chit-chat to try to keep me relaxed/take my mind off it (impossible!)

Hot cup of coffee and a digestive afterwards

In and out in an hour

User

Posted 22 Jan 2024 at 18:43

Had a transperineal biopsy on the 18 January under local anaesthetic.

It was done by a nurse in training overseen by a doctor. The original plan was to take 12 samples but this changed to 24 when I arrived for the procedure. My positive outlook suggested that this was to give the nurse additional practice. :) She had a few ‘misfires’ meaning more than 24 ‘shots’.

Next to no pain during the procedure except for a couple of times I felt a very small sting from the needle.

A little bit of blood when I went to the toilet at the hospital and zero since. No pain whatsoever. Not got as far as finding out how much blood is in my semen.

I hope the above helps someone about to go through this.

Edited by member 22 Jan 2024 at 18:45 | Reason: Not specified

User

Posted 24 Jan 2025 at 14:38

I had a transperineal targeted biopsy with 24 cores taken under a local aesthetic.

The biopsies were very tolerable, as others have said it's like a flicking elastic band at worse.

The ultrasound probe in the back passage was uncomfortable but very tolerable.

The initial local aesthetic was the worse bit of the whole procedure, the deeper injections did hurt but its very quick.
I just grittted my teeth, one of the nurse held my hand for that bit and comforted me.

After effects have been minimal, initial first pee a small amount of blood and weakish flow, but no other blood in the urine after that.
Normal flow returned after 12hrs.

My urologist said he can see on the ultrasound if the prostate is badly inflamed after the procedure, if it would cause a restriction of the urethra to restrict peeing, but said its very rare to ever see this.

Mild post procedure soreness in the area where the needles went in, and similar in the back passage from the probe.
I didn't take any painkillers afterwards, these symptoms rapidly declined over a few days.

Its the unknown with these procedures, but I would say to anyone please don't worry the nursing team and consultant will put you at ease.

Edited by member 24 Jan 2025 at 15:38 | Reason: Not specified

User

Posted 13 Feb 2025 at 17:02

We are all different so of course my experience will be different from others so here goes.

After an mri scan i was quickly booked in for a tp biopsy under local anaesthetic but unfortunately we had to abandon the procedure because I couldn't handle the pain level of the probe in the rectum so the consultant very kindly explained the options to me and I opted to go again but with a general anaesthetic two weeks later (I e. Today) at 0730.

The whole procedure took about 20 minutes from falling asleep to waking up, I have been very lucky in as much as I have experienced no blood in either my pee or my poo. (It's now 5.00pm )

The painkillers are wearing off and my "rusty sherries badge" is a bit tender although far from worthy of painkillers and taking a pee is a little uncomfortable inside, presumably where the urethra passes through the Prostate.

So the upshot of this word salad is......... General Anaesthetic every time! It's not a problem.

Keep on rocking and stay strong

Muzza

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