Jc76,

Thanks for your response!

My MRI targeted biopsy was transrectal and under general anesthesia. I experienced little to no general pain immediately afterwards and no infection. In fact, the first week I was pleased with my results and thought everything was "as expected".

Initially I had the typical blood in urine experience, but that cleared up in two days.

My issue first occurred when my wife and I came together the first time…I experienced a lot of blood, much more than I was expecting and the pain, on my left side, was almost excruciating; so much so that we refrained for a couple of weeks.

The second time was still painful. At that point I became somewhat concerned, but I thought I just needed more time.

This went on for several more weeks.

It was not until ~9-10 weeks after my biopsy that the pain subsided to the place where I could say I was comfortable.

Although I didn't search much, I could not find a satisfactory explanation of my experience. I just chalked it up as being one of those “unfortunate few”.

Even now I experience just a “tinge” of an issue on my left side, which I have just learned to live with.

Recently I decided to do a “deep dive” to see what I could find out about my experience.

Via OpenEvidence I found out that my experience is a known complication of prostate biopsy (apparently rare) but the potential for it happening increases when a large number of cores are taken.

According to my research, the cause is due to nerve damage and possibly tissue scarring that places pressure on these sensitized nerves. According to these sources, if this occurs it can take from 6-24 months, up to 3 years, to fully restore the damaged nerves (sounds similar to restoration of function after experiencing ED after surgery).

I speculate that my particular mpMRI result was probably a factor for this complication.

In my case, three mpMRi lesions were targeted, along with the standard 12 core assay.

A large (2.2 x 1.1 cm) PIRAD 5 lesion (on my left side) was targeted with 4 cores (1.5, 1.4, 0.8 and 1.0 cm in length). They were all found to be Gleason 3+3, with 5% involvement.

Besides this, a 1.1cm left lateral base core was taken which was also found to be Gleason 3+3, with 5% involvement (0.04cm in length - a tiny amount). The interesting thing about this particular core was that it was also labeled with "perineural invasion".

Although I’ll probably never know for sure, I wonder if taking 5 cores from within a very small space (2.2 x 1.1cm), where one core actually pierced through a nerve, is the cause of my experience.

I'm sure this is a lot more than anyone is really interested in knowing, but that's everything I currently know about my situation...

Like a typical man, I've kept all this to myself up until now (as I said its a minor annoyance); however, since it has been 15 months I do plan to discuss with my urologist.