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Prostate Biopsy Complication: Painful Orgasm (Dysorgasmia)
Diagnosed in October 2023 with low volume Gleason 3+4, decipher 0.22. Post biopsy PSA’s have average 6.2, compared to 7.8 prebiopsy.
My 12 month mpMRI indicated only the largest of the original three (PIRADS 3, 4 & 5) lesions was visible and it had reduced T2 and DWI/ADC signaling so everything is looking good regarding the MRI and reduced PSA.
It took me more than 2 months to recover from my 1st biopsy (21 cores) and I’m not looking forward to getting another.
Actually, even after 15 months, I still experience a low level groin soreness where tissue scar may have formed, near a nerve, after the biopsy procedure. Nothing major, more of an annoyance and a minor aggravation.
I found out this is a recognized complication of prostate biopsies; especially for those having large numbers of cores taken.
Has anyone experienced this biopsy complication?
If so, how long did it last and did you find anything to alleviate it…or did it eventually just go away?
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Hey my heavy friend, ain’t seen nothing from Ole Phil except likes and hugs. You alright? I mean no shit, are you ok? I’d really like to know. Bob
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1 ReactionYou da man Phil I don’t mind saying that I’m still worried about you. I need some of that magic usage of the English language. ( lord knows it’s been bastardized for far too long!) come on Phil call me a dick head or something in that unique style of collaboration . You know- like Cheech & Chong said, “Get down so funky it makes my lawn die” I shouldn’t press you though, it’s just my way of saying I miss ya man and you’ll be the first to know what happens in Cleveland- good or bad. Stay Phil. Your friend, Bob
I’m still here, Bob, no worries…I try to comment only on my own experiences or any new research out there…I try to keep it light, but nothing more than that.
Good luck on your Cleveland Clinic consult!! Best,
Phil
Thanks Phil, I feel better already and am relieved that you just didn’t feel you had anything to offer that was new or different- this I understand. Guess I was being a little greedy trying to get you to talk. I’m just glad you’re okay, okay? I’ll give you a holler when I’m done with Cleveland. Going up a day early. I mean while I’m there can’t hurt to find out what “they” mean by “Cleveland rocks!” Later, Bob
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1 ReactionPersonally I would only recommend one Dr. to do a guided biopsy and that's Dr. Jon Hudson in Winston-Salem. My Urologist wanted me to go to Charlotte, NC to have it done but after numerous phone calls to the practice that was supposed to do it and getting different info each call I lost faith in them and started doing my own research and found Dr. Hudson. During my first biopsy before he came in the assistants told me I had picked the absolute best person to do this. I had a little bleeding for about a week after the biopsy but only a light tinge at the beginning of urination. The second one was done using new equipment that had just been installed in Dec. 2024, he had two assistants and one med student with him. I got my Gentamicin shot, I believe it was, a head of time like the first one. I know the thought of them going through your rectum and into the Prostate sounds terrible and it's no fun that's for sure. With my second I had a bit more pain on the way home but only had one bloody tinge urination.
Off Topic here: My Prostatectomy was done May 5th, 2025 by a local surgeon that came highly recommended and also serves as the medical director of robotic steering committee, and assistant professor with Campbell University School of Osteopathic Medicine..
These are my two biopsy results:
Prostate Biopsy 09/21/22
1. Prostate, "Les 1 Rt posterior lateral peripheral zone", needle core biopsy:
-Prostatic adenocarcinoma, Gleason score 3+3 = 6, grade group 1, involving 10% of 1 core
2. Prostate, right base, needle core biopsy:
-Prostatic adenocarcinoma, Gleason score 3+3 = 6, grade group 1, involving 5% of 1 core
3-7. Prostate, right mid, needle core biopsy:
-Benign prostate tissue with atrophy
Prostate Biopsy 01/30/25
Prostate, lesion 1 right posterior lateral mid, needle core biopsy:
- Prostatic adenocarcinoma, Gleason score 4 + 3 = 7 (Grade group 3), involving 70% of one core.
- Prostatic adenocarcinoma, Gleason score 4 + 3 = 7 (Grade group 3), involving 40% of the second core.
- Gleason score 4 pattern accounts for approximately 90 % of the tumor.
2. Prostate, right base, needle core biopsy:
- Prostatic adenocarcinoma, Gleason score 4+4=8/10, (Grade group 4), involving 1 of 1 core, accounting for approximately 10% of total volume of biopsy tissue.
3-7. Prostate, right mid, needle core biopsy:
- Benign prostatic tissue.
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2 ReactionsJust want to comment that here at my local university center of excellence, a few days before my biopsy they had me come into the doctor's office for a quick "butt swab" (my technical term) for a bio analysis.
I suspect that's just to make sure i didn't have any antibiotic-resistant infection there, which might have affected their choice of antibiotics ( or something...)
The procedure itself, also trans rectal, really wasn't a big deal in my case, really just more some discomfort a opposed to actual pain. I suppose I might have preferred having had fewer that ten or so people in the room, but I guess that's part of it's being at a university hospital.
I just found it a little em-bare-assing.
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4 ReactionsYeah…at least I was unconscious when I was mooning a bunch of strangers 😂
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2 Reactions@handera Just ran across your thread and I am experiencing very similar symptoms 1 month after biopsy. Hope you are doing better and just wondering if you ever got a diagnosis or treatment for this?
@ireland1964
Sorry to hear that you may be experiencing similar post-biopsy issues.
The medical term for the issue is dysorgasmia, also called odynorgasmia.
One can find a limited amount of info about problem, if one does the research.
My urologist acknowledged it can occur, after a biopsy, and (apparently) in as many of 15% of men, post RALP, according to a PCF article.
https://www.pcf.org/patient-support/side-effects/sexual-health/dysorgasmia/
The chances of being affected after a biopsy increase when a larger number of biopsy cores are taken...in my case 21 cores.
Here's a 2020 research paper that addresses dysorgasmia directly. https://pmc.ncbi.nlm.nih.gov/articles/PMC7707127/
The paper indicates:
"Our understanding regarding painful ejaculation is very limited and only a few articles have revealed insight into this topic...This is a poorly understood phenomenon, therefore mostly ignored.".....that last comment sort of sums up my follow-up experience, regarding dysorgasmia, with the medical establishment.
The good news, in my case, was that the worst was over in 9-10 weeks and it's one of those things you just put out of your mind, when the experience begins to resolve on its own.
The research paper addresses potential treatments, depending upon the presumed cause.
As one who thinks "the less medication the better", I was glad to leave it as a minor annoyance, once the effect decreased to a "background noise" level, 3 months after biopsy.
I’m scheduled for a trans rectal with only lidocaine. I’m freaking out because I had this 15 years ago and still recall the discomfort.
I’m considering contacting Mayo Jacksonville. Do they do trans perineal? Any idea how long it takes to get in and get biopsy. I’ve had MRI on Pi Rads 4 lesions