Biopsy Infection

@tooters27, I wanted to check in to see how you are doing. Has the infection cleared? Have you thought about getting a second opinion?

@tooters27
You will see those on MCC leaning toward transperineally versus transrectal. Increased infection is just one of the reasons I insisted on transperineally.

There is a 1-2% additional risk of infection when done transrectal (per my Mayo urologist). Did they do a culture prior to your transrectal to see what atdditional antibiotics to give you? Were you given antibiotics prior to your transrectal? If you read everyone who got infection by doing transrectal is sorry for that decision and would not do again that way. Some had not problems at all. But weigh the pros and cons and make your own decsions on things like this including your treatments.

The other reason for transperenial versus transrectal is the pain. Yes transrectal will give you localized pain medication to help with pain. However I and many others don't want to be awake and go through the pre, during and after anxiety and stress of having it done through rectum versus scrotrum.

Most transperenial are done with anesthesia and removes the stress and anxiety. For many of us the reduction of stress, anxiety, and removal of the extra infection rish was very important and for others not so important. Is why decision need to be based on what you want what is best for you and your specific cancer and treatments not others.

The ongoing posts are that urologist push surgery and R/O push radiation. This may be the case with others experiences but not mine. I go to Mayo Jacksonville. My urologist who did my biopsies referred me to Mayo R/O not surgery. He did go over all the different type of treatments but he did not push surgery and referred me R/O for additional consultation. My R/Os again went over all the different treatment plans inlcuding surgery, AS, radiation, and other treatments and asked me to let him know which way I wanted to proceed.

I post this as there are many experienced and professional urologist like mine that have the patients interest first and not theirs. Yes it may be hard to find them but they are out there. The motto of Mayo is "Patients First." My Mayo Jacksonville urologist and my Mayo R/Os, and UFHPTI R/O echoed that motto.

Urologists are moving to transperineal. My doc was excellent and it was 10-15 minutes taking 12 samples, targeted with mri map of areas of concern, guided by ultrasound.

He numbed up the area with lidocaine and I was pleasantly surprised that it was painless. I brought some earbuds to play music to reduce stress and the pain I expected, but never put them on. We chatted as he worked and it was done.

I requested trans-perineal (which, BTW, is *not* through the scrotum) because of the lowered infection risk (where better to find pathogens than your rectum?). Also asked for and got anesthesia.

Worked fine (other than I didn't like the biopsy result, sigh). No infection, zero pain, just blood (expected, and not an issue). Only nuisance is anesthesia prep and post procedure requirement for a responsible adult to pick you up and take you home.

When I had fiducial markers and Space OAR implanted - for proton radiation therapy, they did it the same way (I think that's standard). No problem other than the SpaceOAR feels weird (it'll dissolve in time, I'm assured).

Did the antibiotics take care of the infection finally?

When referring to having transperenial biopsies, markers, Space/Oar where the needles are put in area between anus and start of testicle area what is this area called?

I know when I had transperenial biopsies I was under anesthesia. When I had my markers and Space/Oar it was done transpernial but was not put under anesthesia. They did use a pre anxiety medication, numbing, and laughing gas. I also (and this is quite graphic) them lifting my testicles up and taping them up an away.

It was the fear what was being done versus any real pain that I expereinced. I had laughing gas (you take as need on your own there) bot do not remember laughing. When I made a comment to tech about not laughing he said that is not what you said a couple of minutes ago. So don't know if laughing gas brings you to another level of consciousness or awareness.

Even when done transperineal (markers, Space/Oar) the R/O ordered a smear test for specific antibiotic I would be put on.

The area between the anus and scrotum is called the perineum.

@dgd1953
Thanks. Now that I know that I can say my perineum has really been through hell. My urologist used my perineum to do my biopsies, markers, and space/oar. And quite frankly I insisted my biopsies be done that way.