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MRI showed abnormality / biopsy imminent

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User
Posted 29 Nov 2023 at 21:58

I’m looking for advice about TRUS biopsy. My MRI showed an abnormality which the dr said could be prostatitis but only a biopsy will tell. I’m  booked for Monday 11th Dec, but the leaflet suggests I’ve a 1 in 10 chance of getting an infection, and urine retention! 1 in 50 of getting sepsis and erectile dysfunction. Any advice or experience you can share as it sounds as if this is a dangerous procedure of maybe I’m being a coward. I’m not sure I want to go through with it. I know I’m lucky to have NHS doing all this but would be grateful for experience x

User
Posted 30 Nov 2023 at 11:35
Like the other contributors, I too had a TRUS back in November 22. I was given an antibiotic to take the morning of the procedure. It was quite straightforward - the first couple of injections were like wasp stings and taking the core samples made me wince but not really painful. I drove home afterwards and took a couple of paracetamol and it was fine.

No infection or problems apart from ejaculating blood for a week or so - looks scary as hell but soon cleared up. Just keep the wife away from it otherwise she will use it as an excuse never to go near it again :) :)

User
Posted 30 Nov 2023 at 00:30

Are you sure it is a TRUS biopsy? I don't doubt that is what is says on the patient information leaflet, but that probably is an out of date leaflet. The reason I say that, is that most NHS hospitals are doing transperineul biopsies now, which do have much lower risks.

I had a TRUS biopsy five years ago, with no I'll effects, but I was quoted a risk of sepsis at about 1 in 30, none of the other risks were quoted to me. As my PSA was mid 20s I didn't have much choice. It may be worth asking if you can have a transperineul biopsy instead. They may have to refer you to a different hospital. I don't know how high a risk your cancer is, but prostate cancer is a slow disease and I would gladly wait a month longer for a safer biopsy.

 

Dave

User
Posted 30 Nov 2023 at 07:28

Morning mate,

Like Dave said, I thought they were doing away with TRUS biopsies. 

I had one almost a year ago. It wasn't a problem. It was just a case of lying on your side, on a bed, knees up to your chest and thinking of England. 

They numb your bum, grease it up, and insert a tool of some sort to take a few core samples from the old prostate. I had 15 cores taken and remember hearing a click and feeling a very slight twinge everytime they took one.

The procedure only took a few minutes.  Afterwards I commented to the doctor on how much easier it had been than I feared.

He said that was because I was relaxed and had a 'receptive anus' (Ooh Matron.) The most irritating thing about it was I didn't wipe all the lube from down below and my under crackers kept sticking to my bum.

Before they'd  let me ago I had to give a urine sample. "Wee in this" the nurse said, clutching a cardboard carafe. "What from here?!!", I said.

On completion, I walked outside to the car, my wife was driving, because I'd been advised not to. I told her how easy it had been, and bragged about my receptive anus. She said," That's amazing! I've always found you such an awkward a*se hole."

Try not to worry mate, every medical procedure carries risks. I basically ignore them or otherwise I'd never have anything done. There was no pain afterwards, only a bit of blood in my pee for a while, and your semen looks like cheap tomato ketchup for a bit, so be prepared.

Best of luck.

 

Edited by member 30 Nov 2023 at 07:35  | Reason: Typo

User
Posted 30 Nov 2023 at 11:26

Originally Posted by: Online Community Member

The lady on the phone said rectum so assume it’s the old fashioned one, but I could phone and ask if the other is available. However I think I’m overthinking it all. 

It's natural to overthink things when you're a bit anxious and dealing with something new.

As I said, my first biopsy was TRUS and it wasn't bad.

My second, because they'd found the two tumours had grown, was transperineal under general anaesthetic. I was told this was a more accurate biopsy and they took 24 cores. It was a doddle, but had the same, blood in urine and semen, side effects.

https://www.nice.org.uk/guidance/dg54/documents/final-scope

The above is a right riveting read. 🙄 Page 7, 3rd full paragraph, maybe of interest to you. 

Adrian

Edited by member 30 Nov 2023 at 11:43  | Reason: Not specified

User
Posted 30 Nov 2023 at 11:48

Originally Posted by: Online Community Member
Just keep the wife away from it otherwise she will use it as an excuse never to go near it again :) :)

🤣 Yeah, as if they don't already have enough.

 

User
Posted 30 Nov 2023 at 15:20

Originally Posted by: Online Community Member

https://www.nice.org.uk/guidance/dg54/documents/final-scope

The above is a right riveting read. 🙄 Page 7, 3rd full paragraph, maybe of interest to you. 

Adrian

I sat on the committee, as a lay member, which created that wonderful document.

Dave

User
Posted 30 Nov 2023 at 15:45

Originally Posted by: Online Community Member

I sat on the committee, as a lay member, which created that wonderful document.

Well done mate.  It's one of many similar documents on my PC bookmarks.  I've been in a bit of a dispute with a Trust and ended up reading hundreds of pages of NICE guidelines. Even as a layman, I find them relatively easy to understand. The problem I've found is they are only guidelines, and seem far to open to interpretation. Some clinicians set them in stone when it suits, then almost dismiss them, when they don't. It's very frustrating when they seem able to move the goalposts when they want.

Adrian

Edited by member 30 Nov 2023 at 15:59  | Reason: Additional text.

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User
Posted 30 Nov 2023 at 00:30

Are you sure it is a TRUS biopsy? I don't doubt that is what is says on the patient information leaflet, but that probably is an out of date leaflet. The reason I say that, is that most NHS hospitals are doing transperineul biopsies now, which do have much lower risks.

I had a TRUS biopsy five years ago, with no I'll effects, but I was quoted a risk of sepsis at about 1 in 30, none of the other risks were quoted to me. As my PSA was mid 20s I didn't have much choice. It may be worth asking if you can have a transperineul biopsy instead. They may have to refer you to a different hospital. I don't know how high a risk your cancer is, but prostate cancer is a slow disease and I would gladly wait a month longer for a safer biopsy.

 

Dave

User
Posted 30 Nov 2023 at 07:28

Morning mate,

Like Dave said, I thought they were doing away with TRUS biopsies. 

I had one almost a year ago. It wasn't a problem. It was just a case of lying on your side, on a bed, knees up to your chest and thinking of England. 

They numb your bum, grease it up, and insert a tool of some sort to take a few core samples from the old prostate. I had 15 cores taken and remember hearing a click and feeling a very slight twinge everytime they took one.

The procedure only took a few minutes.  Afterwards I commented to the doctor on how much easier it had been than I feared.

He said that was because I was relaxed and had a 'receptive anus' (Ooh Matron.) The most irritating thing about it was I didn't wipe all the lube from down below and my under crackers kept sticking to my bum.

Before they'd  let me ago I had to give a urine sample. "Wee in this" the nurse said, clutching a cardboard carafe. "What from here?!!", I said.

On completion, I walked outside to the car, my wife was driving, because I'd been advised not to. I told her how easy it had been, and bragged about my receptive anus. She said," That's amazing! I've always found you such an awkward a*se hole."

Try not to worry mate, every medical procedure carries risks. I basically ignore them or otherwise I'd never have anything done. There was no pain afterwards, only a bit of blood in my pee for a while, and your semen looks like cheap tomato ketchup for a bit, so be prepared.

Best of luck.

 

Edited by member 30 Nov 2023 at 07:35  | Reason: Typo

User
Posted 30 Nov 2023 at 07:58

Thanks Dave, that’s really helpful 

User
Posted 30 Nov 2023 at 08:01

Thanks Adrian (I assume) that’s also really helpful. The lady on the phone said rectum so assume it’s the old fashioned one, but I could phone and ask if the other is available. However I think I’m overthinking it all. 

 

User
Posted 30 Nov 2023 at 11:26

Originally Posted by: Online Community Member

The lady on the phone said rectum so assume it’s the old fashioned one, but I could phone and ask if the other is available. However I think I’m overthinking it all. 

It's natural to overthink things when you're a bit anxious and dealing with something new.

As I said, my first biopsy was TRUS and it wasn't bad.

My second, because they'd found the two tumours had grown, was transperineal under general anaesthetic. I was told this was a more accurate biopsy and they took 24 cores. It was a doddle, but had the same, blood in urine and semen, side effects.

https://www.nice.org.uk/guidance/dg54/documents/final-scope

The above is a right riveting read. 🙄 Page 7, 3rd full paragraph, maybe of interest to you. 

Adrian

Edited by member 30 Nov 2023 at 11:43  | Reason: Not specified

User
Posted 30 Nov 2023 at 11:35
Like the other contributors, I too had a TRUS back in November 22. I was given an antibiotic to take the morning of the procedure. It was quite straightforward - the first couple of injections were like wasp stings and taking the core samples made me wince but not really painful. I drove home afterwards and took a couple of paracetamol and it was fine.

No infection or problems apart from ejaculating blood for a week or so - looks scary as hell but soon cleared up. Just keep the wife away from it otherwise she will use it as an excuse never to go near it again :) :)

User
Posted 30 Nov 2023 at 11:48

Originally Posted by: Online Community Member
Just keep the wife away from it otherwise she will use it as an excuse never to go near it again :) :)

🤣 Yeah, as if they don't already have enough.

 

User
Posted 30 Nov 2023 at 12:43

Thanks very helpful, I had a read and have saved it to my phone for when I go in. I called them this morning but there was nobody available to ask what I am getting but they said someone will call back.

User
Posted 30 Nov 2023 at 12:44

Very encouraging Steve, thank you.

User
Posted 30 Nov 2023 at 14:09

I had a TRUS biopsy in 2018 before LATP (local anesthetic transperineal, but not a template biopsy) were deployed. I had no problem with it at all, and they are not as undignified as the current LATP biopsies.

ED wasn't mentioned with mine. We do now know that each biopsy potentially has a minor effect on ED, but not anything most people will notice with just one or two of them. That's more of an issue for men on Active Surveillance for many years who have many biopsies over that time. I don't know if there's a risk of more serious ED from just a single biopsy.

Oh, and don't be surprised if your semen looks like tomato ketchup afterwards - that's normal.

User
Posted 30 Nov 2023 at 15:20

Originally Posted by: Online Community Member

https://www.nice.org.uk/guidance/dg54/documents/final-scope

The above is a right riveting read. 🙄 Page 7, 3rd full paragraph, maybe of interest to you. 

Adrian

I sat on the committee, as a lay member, which created that wonderful document.

Dave

User
Posted 30 Nov 2023 at 15:45

Originally Posted by: Online Community Member

I sat on the committee, as a lay member, which created that wonderful document.

Well done mate.  It's one of many similar documents on my PC bookmarks.  I've been in a bit of a dispute with a Trust and ended up reading hundreds of pages of NICE guidelines. Even as a layman, I find them relatively easy to understand. The problem I've found is they are only guidelines, and seem far to open to interpretation. Some clinicians set them in stone when it suits, then almost dismiss them, when they don't. It's very frustrating when they seem able to move the goalposts when they want.

Adrian

Edited by member 30 Nov 2023 at 15:59  | Reason: Additional text.

User
Posted 11 Dec 2023 at 17:21

Well i had the TRUS biopsy this afternoon and as you all said wasn’t as bad as I thought. They say I was 3/5 on MRI score and they took 6 cores from right and 8 from left and say results in 4-5 weeks. Not feeling too sure yet and hopefully no infection or bleeding next few days. I got one antibiotic 30 mins before and I’ve to take one more in 6 hours. 

 

thank you for support 

 
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