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User
Posted 05 Feb 2026 at 14:15

Hi,

My name is Tony, Im 71 years old. Last year after my doctor referred me to the urology department with incontinence issues. In previous years I have had PSA tests and all come back ok. After a bladder ultrasound, cystoscopy (bloody painful) I had an MRI which came back as level 3. in two weeks time I am due for a freehand transperineal prostate biopsy. Both my wife and I are rather worried about the procedure (i knew i shouldnt have watched a video of it) and the outcome. Im told I can go home the same day, Is it painful?what can i expect? how long to get results?

Thanks for any help

User
Posted 05 Feb 2026 at 16:07

if you add PSA etc to your profile it will help to get more personal advice. 

Results from the biopsy is very dependent on local histology department. From a few days to several weeks.

The biopsy is not pleasant, but straight forward. I was on my way home about 15 mins after finishing.

PIRADS 3 is intermediate so not a strong indicator of a cancer outcome. 

User
Posted 05 Feb 2026 at 17:18

PSA of less than 5 doesn’t seem very high men in their 70s could easily have prostates greater than 50cc so reasonable to assume PSA of 4-5 is normal range. 

Are there other risks involved especially as a general aesthetic is not usual for a biopsy. 

User
Posted 05 Feb 2026 at 18:04

PSA value appropriate for a particular age-range is a measure of risk of cancer but more importantly, in my experience, the rate of rise is more significant. So it is best to record and observe the rate of rise. Had I relied on my GPs (two of them) who did not think a sudden rise in my PSA wasn't significant, I would have been looking at stage 3/4 cancer.  However mine was caught in time, I had a privately funded prostatectomy 15 years ago and I am still free of cancer.

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 06 Feb 2026 at 01:20
You may find having a catheter uncomfortable (I did) and most likely there will be a small amount of blood in the urine for a time. I found that sitting back rather than upright or forward took some pressure off the transperineal area for the first few days, which helped.

Waiting time for results can very between hospitals and if further tests are recommended.

With BPH, your Prostate being larger, your PSA will be higher than if you had a more normal sized Prostate.

Barry
User
Posted 07 Feb 2026 at 12:57

If you haven’t got the NHS app I would recommend it especially if your GP has set up online access. The app will have all your records, at least those that have been added, you get the full set of results not just the headlines from the GP. Also hospital records and letters. You can even sign for medical procedures electronically using the app. No waiting for a letter to arrive. 

User
Posted 07 Feb 2026 at 17:16

What does 'freehand ' refer to?

Husband has had a transperineal biopsy. It was fairly OK, according to him. He was fine a few days later. He was given anti biotics when he had a rectal biopsy. He did have slight trace of blood for a few days. Definitely did not need a general anaesthetic.  Was done very efficiently at the Urology depth. I believe the results took a couple of weeks. 

User
Posted 07 Feb 2026 at 17:36

"Freehand" as opposed to "template". Older equipment used a template as a guide for the needles, it was fiddly to use. New equipment is just held in place by hand. I don't think it makes any difference for the patient.

Dave

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User
Posted 05 Feb 2026 at 16:07

if you add PSA etc to your profile it will help to get more personal advice. 

Results from the biopsy is very dependent on local histology department. From a few days to several weeks.

The biopsy is not pleasant, but straight forward. I was on my way home about 15 mins after finishing.

PIRADS 3 is intermediate so not a strong indicator of a cancer outcome. 

User
Posted 05 Feb 2026 at 16:44

My PSA is 4.85. The biopsy is being done under general anethsetic. I am unable to take Tamsolosin due to side effects so the surgeon has warned me because of this I may well have a catheter for a while after the biopsy.

Edited by member 05 Feb 2026 at 17:02  | Reason: Not specified

User
Posted 05 Feb 2026 at 17:18

PSA of less than 5 doesn’t seem very high men in their 70s could easily have prostates greater than 50cc so reasonable to assume PSA of 4-5 is normal range. 

Are there other risks involved especially as a general aesthetic is not usual for a biopsy. 

User
Posted 05 Feb 2026 at 17:51
The surgeon say he prefers general as the victim (my words) stays still. He says i have BPH and apparently its gone from 40cc to 64cc in size. He is planning on aquablation at some point i think.
User
Posted 05 Feb 2026 at 18:04

PSA value appropriate for a particular age-range is a measure of risk of cancer but more importantly, in my experience, the rate of rise is more significant. So it is best to record and observe the rate of rise. Had I relied on my GPs (two of them) who did not think a sudden rise in my PSA wasn't significant, I would have been looking at stage 3/4 cancer.  However mine was caught in time, I had a privately funded prostatectomy 15 years ago and I am still free of cancer.

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 06 Feb 2026 at 01:20
You may find having a catheter uncomfortable (I did) and most likely there will be a small amount of blood in the urine for a time. I found that sitting back rather than upright or forward took some pressure off the transperineal area for the first few days, which helped.

Waiting time for results can very between hospitals and if further tests are recommended.

With BPH, your Prostate being larger, your PSA will be higher than if you had a more normal sized Prostate.

Barry
User
Posted 07 Feb 2026 at 12:19
I went to the doctors yeaterday to get confirmation of my PSA levels. Once I had been interogated by the gestapo receptionist as to why i wanted the information, she finally relented and gave me what i asked for. in 2023 it PSA was 4.85, i had another test last year, that i had forgotten about and it was 6.09. According to GP records at the time this was normal. I asked for a new test and I was told its not due till April and to come back then!
User
Posted 07 Feb 2026 at 12:57

If you haven’t got the NHS app I would recommend it especially if your GP has set up online access. The app will have all your records, at least those that have been added, you get the full set of results not just the headlines from the GP. Also hospital records and letters. You can even sign for medical procedures electronically using the app. No waiting for a letter to arrive. 

User
Posted 07 Feb 2026 at 17:16

What does 'freehand ' refer to?

Husband has had a transperineal biopsy. It was fairly OK, according to him. He was fine a few days later. He was given anti biotics when he had a rectal biopsy. He did have slight trace of blood for a few days. Definitely did not need a general anaesthetic.  Was done very efficiently at the Urology depth. I believe the results took a couple of weeks. 

User
Posted 07 Feb 2026 at 17:36

"Freehand" as opposed to "template". Older equipment used a template as a guide for the needles, it was fiddly to use. New equipment is just held in place by hand. I don't think it makes any difference for the patient.

Dave

User
Posted 20 Feb 2026 at 17:00

I had the biopsy a week ago now  Unfortunatley i couldnt pee afterward so i had a catheter for a couple of days, which was more painful than the biopsy. now its been removed i find myself urine incontinent  I thought it was just my body getting used to being in control, but its lasted several days now. is this normal? thanks for any help

User
Posted 20 Feb 2026 at 19:23

Originally Posted by: Online Community Member

if you add PSA etc to your profile it will help to get more personal advice. 

Results from the biopsy is very dependent on local histology department. From a few days to several weeks.

The biopsy is not pleasant, but straight forward. I was on my way home about 15 mins after finishing.

PIRADS 3 is intermediate so not a strong indicator of a cancer outcome. 

But was yours a transperineal biopsy? I think probably most are still under anaesthesia for this type of biopsy, certainly my first one was althought my second one was under heavy sedation and local anaesthetic. Recovery was reasonably quick I found, about three days.  It will also depend on how many cores are taken.

Barry
User
Posted 20 Feb 2026 at 19:35

Hi Barry 

My husband had a rectal biopsy last year. Followed by a perineal one a few months later. Very straightforward, certainly no general anaesthetic. For the first one he was given some antibiotics, for the second one nothing. He had to wait for a while till he'd passed urine OK, then he dressed and we went home. Was delicate for a few days, but then fine 

 
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