Just how painful IS a transperineal biopsy?

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.

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. 

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! 

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.

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

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