Upcoming Second biopsy: Nervous but better prepared this time

From a guy who just went through the whole path: you're doing great! I don't know if you can take 1,000mg of Tylenol beforehand but certainly afterwards for the discomfort will probably help.

But the good news: I'm only 6 years your junior and was able to get through a total prostatectomy and have had zero erectile issues (even within 24 hours of surgery, which was a little weird) and today got my catheter out after a week and not a single drop of incontinence thus far (after several full normal bladder emptying sessions).

I say that because sometimes it's hard to find the good news online, but there is some to be found! If things stay like this then I'll be mostly normal for all this worrying and sleepless nights. My perineum hurts, but that was expected, and that'll stick with me for some weeks (got a special gel cushion with the middle out to help). Take it one day at a time!

I has 3 biopsies 15+ years ago. Had no recollection about a real infection problem or other issues, though I am sure they told me about it? Had no problem as a result. Pulled up my pants and went home. Felt no side effects of the procedure after leaving. What bleeding?

It sounds like you had a real problem, the first time. Hopefully after this next procedure you will have more normal results.

Did you try and get a transperineal biopsy in order to reduce the risk of infection and increase the areas they can check?

For me I just felt more of pressure on my prostate for a day or two, passed a little blood in my urine but mostly it was just a bit of a bloody mess around the backdoor right afterwards. They did give me a "super antibiotic" to take the morning of to keep off infection, but considering the area where this all happens I can see how infection can be a real concern when they are poking holes in your gland.

My first biopsy was the one where they stick the MRI probe in you and then do the core collection. I don't know what type they are doing coming up.

Mine was an ultrasound with the needle for the cores. 12 cores, the first 5 were ok, then I was counting each one and heard the loud click and dreaded the sampling. Had to be done, and it's easier than recovering from surgery so, here we all are!

I was asleep with mine as they gave me propenol. I know some prefer a bullet to bite on but I was glad this was their normal procedure.

Sounds like you are all set and will be back here for more info when you are ready for treatment.

Two biopsies for me - April 2023 and June 2024. Both were MRI fusion, ultrasound guided, transrectal procedures. I was asleep (propofol) for both. The first was 13 samples, the second was a "saturation" biopsy - 28 samples.

No pain to speak of either time. Felt some "pressure" - like I needed to have a bowel movement when I really didn't - for 2 or 3 days. No problem with infection, and I don't believe they gave me any antibiotics (might have been something in an IV, but no pills before or after). Minor blood in urine for a few days after each procedure. A little blood in my stool the first time I pooped after the procedure. Bloody/discolored semen for about 10-12 ejaculations after the procedure.

Everyone's experience is different, but for me, the biopsies were pretty easy.

Hope things turn out well for you.

My prayers are are with you my brother ! Let us know how it works out ! James on Vancouver Island .

survivor5280
Can you please tell us where you have this total prostatectomy done?
And by what doctor?
Thank you.

My prostatectomy was performed at UCHealth Highlands Ranch in Colorado.

My situation, like everyone's, may be different than yours, and this may have changed the outcome:

- Younger than many men who get PC at just 54
- Almost complete nerve sparing surgery
- Lymph nodes spared
- Three months of significant fitness training by a personal trainer with emphasis on pelvic floor and core strength BEFORE surgery
- Three months of pelvic floor therapy by a doctor to ensure I was making progress BEFORE surgery
- 5mg tadalafil (Cialis) and l-citrulline (natural supplement extracted from grapefruit) for a month before surgery, both effective to keep your nerve bundles firing and recovering faster, despite no history of previous ED
- Non-standard procedure during surgery called anterior urethropexy, which is usually only done once you have a history of stress incontinence (and in fact my insurance refused to cover it because there was no history) but that has proven 95%+ effective for stress incontinence and helps with general incontinence as well

This is all to say that I went straight to work when I got the news to control the only things within my control and worked very hard to get what I assumed was maybe a few percentage points better chances at continence and erectile function. I felt very good that incontinence would be a non-issue for me, but ED was still a concern - however pelvic floor can help with that as well so long as you do have some nerves spared during surgery.

Three days before surgery, my pelvic floor therapist commented that I had one of the healthiest and strongest pelvic floors she had worked with and wished more men would take the routes that I did before surgery rather than seeing her only after there is a problem to fix.

I hope that helps!