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An Open Warning to men facing an LATP Biopsy

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User
Posted 29 Oct 2026 at 12:00

I want to talk about my experience of the Local Anaesthetic Trans Perineal (LATP) prostate biopsy, having just experienced it firsthand.

Despite being in obvious severe pain, they just carried on, it was an utterly brutalising and distressing. The truly shocking aspect was that for the clinicians in that room, inflicting severe pain and distress on a patient seemed completely routine and of little/no consequence.

The fact is that LATP procedures can be responsible for significant levels of suffering, the clinical data backs this up. The large-scale TRANSLATE multicentre randomised controlled trial, published in The Lancet Oncology, shows that 38% of men find LATP biopsies painful and embarrassing. Furthermore, peer-reviewed registry data reveals that severe, agonizing pain (scoring over 7 out of 10) is reported by roughly 5.9% of men. I was unlucky enough to be in that 5.9%.

While the majority may tolerate it, a significant minority do not. 

If you are a man in the UK being prepared for this procedure, your urologist may push you toward a conscious LATP. You must understand that this pathway is designed primarily for clinical convenience—and it carries a risk that you will suffer in that chair.

Before signing my consent form, I was fed sanitised, well-rehearsed scripts: “well tolerated,” “brief discomfort,” “like an injection at the dentist.” No clinician was honest or forthcoming about the group of men who do not experience it this way. There was zero discussion about alternatives such as sedation.

By sanitizing the language, it avoids a critical truth: for a certain cohort of men, LATP is not "uncomfortable"—it is deeply traumatic. When urologists refuse to validate this, they deny men the ability to give truly informed consent. They make the patients who do experience severe pain feel isolated, or like they have somehow failed a "simple" procedure.

Clinicians in urology should stop pretending this procedure is painless. If you have had a similar experience, please speak up. Men need to know about these experiences before they walk through that door.

Finally, and this is really important, I am not saying don’t have a prostate biopsy if you need one, it could very well save your life. I am saying that be fully informed about what you might experience under the LATP procedure, look past the sanitised scripts and reassurances that you may be provided with and think very carefully if you would rather just opt for sedation.

You do not have to accept an LATP procedure despite the pressure that may be used to rush your decision.

As a patient, you have the legal and ethical right to informed consent.

I sincerely wish that I had never experienced this and opted for sedation, but I can’t change that, I can only recount my story here in the hope it will help other men faced with a prostate biopsy in making a truly informed decision about their treatment.

Edited by moderator 30 Oct 2026 at 12:55  | Reason: Not specified

User
Posted 03 Nov 2026 at 09:40

Hello, mate.

I'm sorry to hear that you found your LATP so painful, embarrassing and distressing. I've been on this forum for three years, having biopsies is often discussed. I think it would be fair to say, that most men find the procedure uncomfortable and embarrassing.

A few, like you have found it very painful, but I suppose that depends on individual pain thresholds. Like my wife often remarks to me, "Thank God, men don't have to give birth"

I remember going for my TRUS biopsy. It was in the middle of Covid restrictions. My wife drove to the hospital, she remained with the car. 

I eventually found my way to the consultant's room. I was very anxious. In a flash, my jeans off and thrown over a chair. Then it  onto the examination bed. I was on my side, knees up to my chest, and thinking of England. He lubbed me, and went straight in.

Not the most pleasant experience, but not nearly as bad as I feared. In fact, I was so pleased I thanked him for 'being gentle with me'

'Some men find it more painful than others, a lot depends on how relaxed and receptive your anus is' he said. 

I was thrown some kitchen roll to mop up the excess lube. I obviously didn't do a very job. As I left the room, my boxer shorts were sticking to my buttocks.

I left the hospital, walking like John Wayne when he'd just got off his horse, across the car park to my car. 

By this time, the lube had soaked through my jeans, so I literally slipped into the passenger seat.

My wife was amused by my temporary discomfort. "How did it go?" She giggled.

"Okay" I said. "Apparently I have a receptive anus."

"How strange" she replied, "I've always found you such an awkward a*sehole."

The above is a street account. We still laugh about it. 😁

Edited by member 03 Nov 2026 at 22:02  | Reason: Typo

User
Posted 03 Nov 2026 at 11:59

I have had that scan and also the rectal type. I arched my back in absolute agony and the surgeon told me to keep still or he wouldn’t be able to do his job. Easier said than done.

User
Posted 03 Nov 2026 at 14:48
I have had the Transperineal Biopsy twice, the last time with local Anaesthetic. Agree it's a bit undignified but I experienced no pain, just a little discomfort. However, I had a Colonostomy procedure under local Anaesthetic and it was the most painful experience of my life, so much so that I cried out and the procedure was abandoned. Yet somebody else I knew found it easy and relatively painless. So one can conclude that there is potential in procedures for a painful experience. Maybe the skill is lacking or insufficient time has been allowed - many of us will have had an injection to numb a nerve in a tooth but the dentist has started before the injection has fully taken effect, or there may be other reasons. Anyway, thank you for the warning. I was lucky with the Prostate one.

Barry
User
Posted 03 Nov 2026 at 15:41

Hi Adrian,

Thanks for your reply and your story about your experience.

Yes, when I first saw that chair, I did think of all the indignities that women have to suffer with much greater frequency, your wife is spot on, if men had to carry babies, the human race would likely have died out years ago!

Yes, the mechanics of the procedure are not great, but you do these things believing the reassurances that at worst there will be minimise discomfort and analogies with a dental procedure and driving all of this, is the spectre of cancer looming over everything.

Yes, you are right, different men will have very different experiences in that chair, and I’m very happy and relieved for the men who find the process as described.

When things do not go to plan, it can rapidly descend into something pretty horrific.

I could have dealt with the embarrassment and indignity of it, but when the local anaesthetic fails and you feel every needle pass like an electric shock and you flinch involuntarily, and they just carry on, it crosses into a very dark place and some men will be left with the psychological trauma as a result.

They don’t mention anything about that in their slick texts used to gain your consent and get your arse in that chair!

In the time since it happened the physical effects have subsided, but the mental aspects have only worsened, I never thought that things would play out the way they did in a modern clinical setting.

So, I am trying to do something positive in posting about my experience which I accept thankfully seems to affect a smaller group of men, but the average man used to sell the LATP procedure was not in that chair that day, and so there will inevitably be casualties of a system that is only geared up for the average guy.

I hope things are good with your health and thanks again for the conversation.

User
Posted 03 Nov 2026 at 15:46

Hi Londonguy - sorry to hear that things didn't go well for you.  I was indeed talking to a recently diagnosed mate who had had LATP  and found the process a bit like yours - he was last on the list and all he could think was that they wanted to finish up for the day.  Another of my mates had his first in a French hospital and he ended up in their A&E as he was haemorrhaging (he went for the GA with his second).

My own experience was completely different. My consultant promised "no pain" and apart from some awkward twinges during sampling where the anaesthetic hadn't taken it basically was.  My perineum was sprayed with the same spray they use on footballers to numb the area before the local was injected and then he tested for the take up of the local.  

Mind you the hand holding nurse did ask me what I used to do for a living and I truthfully said that I used to work for NHS England in Professional Standards - everything  just seemed to go well.....

Best wishes - stay positive

CeePee

User
Posted 03 Nov 2026 at 20:56

"Perhaps at biopsies, the patient should be postioned so that he can hold the consultant's testicles,"

That's very sexist Adrian, - not all consultants have testicles. 😕🤣 

User
Posted 03 Nov 2026 at 22:47

Hi CeePee,

Another witty handle - great!

Well after you are given a severe kicking in your nether regions (if you will excuse the metaphor), do you stay on the floor or do you get back up again?

At least they took the courtesy to tape my scrotum out of the way before they properly went to town, small mercies and all that.

Your mate has my every sympathy and as for your other mate ending up in A&E bleeding out, the poor bugger.

I must admit to being very envious of your experience, I’m sure when you inevitably hear or read “well tolerated” from clinicians it does not send you into a spiral of rage and disgust, which I know is not a particularly healthy or positive perspective to have, but here we are.

Much like the black and blue perineum I hobbled away with, I am sure it will stabilise over time.

That is a brilliant response you gave to the nurse, perhaps you were subsequently moved to the "premier line" as a result …?

Wishing you all the best.

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User
Posted 03 Nov 2026 at 09:40

Hello, mate.

I'm sorry to hear that you found your LATP so painful, embarrassing and distressing. I've been on this forum for three years, having biopsies is often discussed. I think it would be fair to say, that most men find the procedure uncomfortable and embarrassing.

A few, like you have found it very painful, but I suppose that depends on individual pain thresholds. Like my wife often remarks to me, "Thank God, men don't have to give birth"

I remember going for my TRUS biopsy. It was in the middle of Covid restrictions. My wife drove to the hospital, she remained with the car. 

I eventually found my way to the consultant's room. I was very anxious. In a flash, my jeans off and thrown over a chair. Then it  onto the examination bed. I was on my side, knees up to my chest, and thinking of England. He lubbed me, and went straight in.

Not the most pleasant experience, but not nearly as bad as I feared. In fact, I was so pleased I thanked him for 'being gentle with me'

'Some men find it more painful than others, a lot depends on how relaxed and receptive your anus is' he said. 

I was thrown some kitchen roll to mop up the excess lube. I obviously didn't do a very job. As I left the room, my boxer shorts were sticking to my buttocks.

I left the hospital, walking like John Wayne when he'd just got off his horse, across the car park to my car. 

By this time, the lube had soaked through my jeans, so I literally slipped into the passenger seat.

My wife was amused by my temporary discomfort. "How did it go?" She giggled.

"Okay" I said. "Apparently I have a receptive anus."

"How strange" she replied, "I've always found you such an awkward a*sehole."

The above is a street account. We still laugh about it. 😁

Edited by member 03 Nov 2026 at 22:02  | Reason: Typo

User
Posted 03 Nov 2026 at 11:59

I have had that scan and also the rectal type. I arched my back in absolute agony and the surgeon told me to keep still or he wouldn’t be able to do his job. Easier said than done.

User
Posted 03 Nov 2026 at 14:48
I have had the Transperineal Biopsy twice, the last time with local Anaesthetic. Agree it's a bit undignified but I experienced no pain, just a little discomfort. However, I had a Colonostomy procedure under local Anaesthetic and it was the most painful experience of my life, so much so that I cried out and the procedure was abandoned. Yet somebody else I knew found it easy and relatively painless. So one can conclude that there is potential in procedures for a painful experience. Maybe the skill is lacking or insufficient time has been allowed - many of us will have had an injection to numb a nerve in a tooth but the dentist has started before the injection has fully taken effect, or there may be other reasons. Anyway, thank you for the warning. I was lucky with the Prostate one.

Barry
User
Posted 03 Nov 2026 at 15:41

Hi Adrian,

Thanks for your reply and your story about your experience.

Yes, when I first saw that chair, I did think of all the indignities that women have to suffer with much greater frequency, your wife is spot on, if men had to carry babies, the human race would likely have died out years ago!

Yes, the mechanics of the procedure are not great, but you do these things believing the reassurances that at worst there will be minimise discomfort and analogies with a dental procedure and driving all of this, is the spectre of cancer looming over everything.

Yes, you are right, different men will have very different experiences in that chair, and I’m very happy and relieved for the men who find the process as described.

When things do not go to plan, it can rapidly descend into something pretty horrific.

I could have dealt with the embarrassment and indignity of it, but when the local anaesthetic fails and you feel every needle pass like an electric shock and you flinch involuntarily, and they just carry on, it crosses into a very dark place and some men will be left with the psychological trauma as a result.

They don’t mention anything about that in their slick texts used to gain your consent and get your arse in that chair!

In the time since it happened the physical effects have subsided, but the mental aspects have only worsened, I never thought that things would play out the way they did in a modern clinical setting.

So, I am trying to do something positive in posting about my experience which I accept thankfully seems to affect a smaller group of men, but the average man used to sell the LATP procedure was not in that chair that day, and so there will inevitably be casualties of a system that is only geared up for the average guy.

I hope things are good with your health and thanks again for the conversation.

User
Posted 03 Nov 2026 at 15:46

Hi Londonguy - sorry to hear that things didn't go well for you.  I was indeed talking to a recently diagnosed mate who had had LATP  and found the process a bit like yours - he was last on the list and all he could think was that they wanted to finish up for the day.  Another of my mates had his first in a French hospital and he ended up in their A&E as he was haemorrhaging (he went for the GA with his second).

My own experience was completely different. My consultant promised "no pain" and apart from some awkward twinges during sampling where the anaesthetic hadn't taken it basically was.  My perineum was sprayed with the same spray they use on footballers to numb the area before the local was injected and then he tested for the take up of the local.  

Mind you the hand holding nurse did ask me what I used to do for a living and I truthfully said that I used to work for NHS England in Professional Standards - everything  just seemed to go well.....

Best wishes - stay positive

CeePee

User
Posted 03 Nov 2026 at 16:09

Hi Roger,

Great handle!

Thanks for sharing your story even though it’s pretty grim.

I know men are supposed to be “big boys” and they “don’t cry” or should show vulnerability.

Fortunately, I have never subscribed to that b*******, I readily accept that I have my vulnerabilities, that sometimes life will make you cry and that things don’t always go according to plan, especially in the medical world!

When they first said that I needed a biopsy, I went and looked through all the official blurb and believed all the reassuring patter and thought I knew exactly what to expect and thought my experience would be as described, just an everyday, routine procedure that is a bit uncomfortable.

Incredible how quickly the departure from the script happened and continued.

Life can come at you fast and hard! (or repeated stabs of 250mm needles!)


Given your account of your arching your back in absolute agony and the clinician’s response was to complain about his ability to do the job, says to me that that clinician should not be working in a field that is supposed to be compassionate and caring towards its patients.


Maybe he was having a s*** day, maybe you were number 15 on a long list that day and couldn’t be bothered to muster up a bit of humanity 

For him, it was another day at the office and he had to extract so many cores, another procedure to perform as if on some medical manikin, but in fact, on the receiving end was a fully conscious human being that was obviously suffering.

Something I have now come to realise after the event, is the assembly line mentality especially of the LATP pathway, and this I think goes someway to explaining the casual indifference to patient pain and distress displayed by your and mine clinicians.

I hope things are all OK with your health and wishing you all the best.

User
Posted 03 Nov 2026 at 18:07

Hi.

My transrectal biopsy did not bother me other than the embarrassing nature and a bit of a nip when the probe went in.

But thats not to say other men could find it more of an issue or indeed absolutely agonising as you clearly did.

I think you are bang right about informed consent. How on earth can you make an informed decision about something when you are not given a balanced picture?

I was told they could easily do the procedure under general anaesthetic but that recovery would be longer, so I opted for the local and was lucky it didn't hurt me. It would also have been more expensive and complicated so I was definitely steered toward a local.

Just carrying on despite your obvious pain and distress strikes me as similar to the offence of assault and battery. You consented to be assaulted but that consent can be withdrawn. Just like the lady who consented to intercourse but then objected when it became painful and she told him to stop. He didn't and is doing time for rape. Maybe the doctors need a little input on basic law around consent and assault. 

Im sorry it hurt you and more sorry that they carried on regardless. 

Speak to PALS and complain. If you dont they won't know they dropped a clanger and could end up in court. 

Best regards Mick 

 

 

User
Posted 03 Nov 2026 at 19:34

Perhaps at biopsies, the patient should be postioned so that he can hold the consultant's testicles. Then both promise, 'We're NOT going to hurt each other, are we.' 😁

Edited by member 03 Nov 2026 at 21:25  | Reason: Typo

User
Posted 03 Nov 2026 at 20:56

"Perhaps at biopsies, the patient should be postioned so that he can hold the consultant's testicles,"

That's very sexist Adrian, - not all consultants have testicles. 😕🤣 

User
Posted 03 Nov 2026 at 21:18

Originally Posted by: Online Community Member
"Perhaps at biopsies, the patient should be postioned so that he can hold the consultant's testicles,"

That's very sexist Adrian, - not all consultants have testicles. 😕🤣 

I do apologise. Back to the drawing board.

Edited by member 03 Nov 2026 at 23:14  | Reason: Typo

User
Posted 03 Nov 2026 at 22:24

Hi Barry,

Thanks for your reply and relaying your story.

I understand that individuals will experience the same procedure in very different ways, can I ask were both TP done just under local?


It is very hard for me after recent events to understand how anyone would want to be awake for a single aspect of this procedure, but I’m relieved to hear that your LA seemed to work as it was supposed to but sadly it had no effect on the indignity aspect.

Regarding your colonoscopy, why on earth would they make you submit to that fully awake and conscious!? I have a general idea of what that involves and that sounds utterly brutal.

But as you said, you knew of someone that could tolerate it, the thing is you can use the exact same drug and dose on two different people and get two very different outcomes.

I think the problems begin, when clinicians treat the procedure as some form of clinical exercise, and that they only consider the average patient, and the fact that they do it so often and probably are under such pressure to fit a certain number of cases in every day, that at some point they lose sight of the fact that it is a vulnerable human being on that table, not just a sack of flesh that needs to be processed.

Its really sad that to come to this realisation because I know personally from many years of care  in other fields, that the NHS has so many caring compassionate people that are a true credit to their profession.

I think this speaks of an institutional failure, we go to clinicians because we trust them literally with our bodies and have a belief that they have our best interests at heart, and we rely upon them to talk to us as grown men, and that means honesty which from my own experience of the LATP pathway seems to be missing into many cases or viewed as dispensible.

I hope all is good for you and if you do need another colonoscopy or indeed TP biopsy , maybe give conscious sedation a go?

User
Posted 03 Nov 2026 at 22:47

Hi CeePee,

Another witty handle - great!

Well after you are given a severe kicking in your nether regions (if you will excuse the metaphor), do you stay on the floor or do you get back up again?

At least they took the courtesy to tape my scrotum out of the way before they properly went to town, small mercies and all that.

Your mate has my every sympathy and as for your other mate ending up in A&E bleeding out, the poor bugger.

I must admit to being very envious of your experience, I’m sure when you inevitably hear or read “well tolerated” from clinicians it does not send you into a spiral of rage and disgust, which I know is not a particularly healthy or positive perspective to have, but here we are.

Much like the black and blue perineum I hobbled away with, I am sure it will stabilise over time.

That is a brilliant response you gave to the nurse, perhaps you were subsequently moved to the "premier line" as a result …?

Wishing you all the best.

User
Posted 03 Nov 2026 at 23:38

I will relate a little story going back many years ago [hospital names removed by moderators]. I was attending for an operation called 'FESS', undertaken as a day procedure. My operation was to clear blocked sinuses and open the airway. So we were all assembled on beds in this ward kitted out for our various procedures. I received a pre-med injection and then when I could hardly read, somebody came to me thrusting an assent form in my hand just as I was about to be wheeled into theatre. I asked what the risks were and was told if they went too high it could cause Brain Damage. I then asked what the odds of this happening were and was told it was about 1 in 400. So I decided to risk it. However, a man opposite who was hard of hearing was also asked to sign a consent for a hearing operation after the premed. When he asked about his chances of success, he was warned the operation could make his already poor hearing worse. With that he shouted, "Well thanks for the tea and biscuit, I 'm off "as he grabbed his normal clothes and left. Not great communication and organisation then and the inadequate and over pressurised NHS still suffers in various ways.

Edited by moderator 05 Nov 2026 at 13:47  | Reason: As per the OC terms and conditions - individual hospitals should not be named

Barry
 
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