Hi all,

Prostate biopsy report. What actually happens:pain,bleeding,etc...

This is a detailed report of what exactly happens during a
prostate biopsy. Before my procedure I couldnt really find a
comprehensive review, so here's my attempt.

Me, 55 yo male PSA 5.2 No cancer DX BPH.

The Procedure.
-------------------------------------------------------------

The patient goes into a room. The nurse explains what is going
to happen. You put on a gown and are positioned on a table on
your leftside, knees drawn up, with a pillow betwee the knees.

The doctor comes in, explains again what will happen and gives
a brief demo of the ultrasound wand, and the prostate gun.

The gun itself is a plastic tube, like a straw, about a foot
long with a green handle. He shows how it works and tells you
there might be a snap when it fires.  I have heard the snap
bothers some people, but I could barely hear it.

The doctor puts some lido gel into the rectum, and sticks in
the wand. The screen is in front of you, so you can watch all
this.  He manipulates the wand visualizing the anatomy from
several perspectives, and measures the prostate. The wand is
connected to a computer with a mouse, so he draws a line
with the cursor on the screen about the prostate from several angles and
the
computer calculates a size.  Mine was 42G. Normal for a man
my age is 24G. I'm not sure of the difference between Grams
and cc's, but this one was done in Grams.
This part takes 4 or 5 minutes.

The doctor then numbs the prostate with a few lido injections.
This takes maybe a minute. Pain is minimal. Maybe a 2 at the
most. It really is just a slight sting.

He then takes the cores. Origionally he wanted to do 18 sticks,
but I said I didn't want that many, so he very amiably said
he would do 12. It was my choice. He was very agreeable.

The cores are taken very quickly. Maybe 3 minutes and it's done.
Again, the pain is just a brief sting, maybe a 2. I was actually
watching the needles go in on the ultrasound screen. I thought
this would bug me, but it didnt.

That's pretty much it. The whole procedure, start to finish, takes
maybe 10 or 12 minutes. Fear Factor is a 10, actual procedure is a 2.

The Other Stuff.
------------------------------------------------------------------

Pain
-----
OK, about 30 minutes after the procedure, I started to get some
pretty bad pain, which lasted about 2 or 3 hours.  Nobody had told
me about this and I wasnt expecting it. It didnt last more than
a couple of hours, but it wasnt pleasant.
My wife was driving me home, which was good, because if I had had
to do it myself, I would have had a tough time.  I havent heard
anybody mention this pain before so maybe it was just me. Maybe
the lido wearing off. I dont know. After this, there was basically
no more pain, just discomfort. But that 2 or 3 hours was pretty
tough. Worse, because I wasnt expecting it, and didnt know how
long it would last.

Bleeding
---------
I didnt have any rectal bleeding at all. There was no uriniary bleeding
the first day, but days 2 and 3 were substantial bleeding. Bright red
and frequent. Doesnt hurt, but spooky. This stopped after 2 days.
I knew this was coming, but its still pretty gruesome to look at.

I am now about 17 days post and I am still having some bleeding. Not
heavy, but there. The doctor says bleeding can go on for a month or
more,
the prostate being a very vascular organ which gets a lot of sticks
with big needles. 18g, I think. At any rate, he wasnt concerned, but
they never are unless your head actually falls off. This they call
slight discomfort.

Most of the people in the groups, seem to have minimal bleeding, or just
a couple of days. I dont know whats different about me. Maybe its just
that big prostate.

What specifically happens is this:

The urine is clear during the morning and early afternoon. Late
afternoon
or evening, there is some red tinging with the first part of the stream,
then it runs clear. It is not enough to discolor the water in the bowl,
and if you are not actually looking down at the time, you wont notice
it.

I have kind of a theory that this type of trace bleeding may be more
common
thatn most people realize, because, if you are not actually looking for
it, in good light, you wont see it.

Has anyone else had this? Or is it just me?

It seems to be very slowly getting better, but has lasted much longer
than
I was told to expect. This is another example of the stuff they tell you
afterword.

At any rate, the procedure is nowhere as bad as you think it will be, so
I hope this puts at ease anyone who may be having one for the first
time.

BTW, interesting article on overdiagnosis and overtretment of pca.
There seems to be a lot of new research coming out of scandinavia
and holland.

http://sci.tech-archive.net/Archive/sci.med.diseases.cancer/2007-10/msg0
0047.html