Anesthesia for a Prostate Biopsy

I had two prostate biopsies under anesthesia.

But the second one we attempted to do under local anesthesia and I had to stop. I’ve had four major surgeries in the last 30 months and I have a high pain tolerance, but a prostate biopsy with only local was too much.

I had open-heart surgery to replace my cuspid aortic valve, and I need cardiac clearance practically for crossing a street. It’s a complete pain in the ass, but I live near Manhattan and the hospital that did my open heart surgery tends to accommodate me which means I get an appointment two weeks out. So I hear your story very loud and very clear.

But as long as you can tolerate general anesthesia, I’d say that’s the call. In fact for every type of surgery, I’ve had I’ve asked them to give me the most anesthesia they can without killing me. Two cancer is an open heart surgery, and a retinal detachment have been enough pain

Should also add that my prostate surgeon is a bit of a macho man and he gave me a hard time for yelling during my biopsy when I wasn’t completely under. I don’t like the guy so I essentially said TFB if you don’t like it.

Good luck.

If it hurts, it hurts. Sometimes insurance/ Medicare won't pay for general. I had 2 biopsies which were quite tolerable but afterwards were a bit uncomfortable. Motrin took the edge off.

My husband refused general anesthesia and asked for so called "twilight" sedation. It is used during some minor rectal surgeries and for colonoscopy, endoscopy etc.. It just puts you into deep sleep and you wake up much faster with no real grogginess. Surgeon used propofol for biopsy and I wish I had some of it since my husband woke up in , lets say ,extremely high spirits 😜, joking and entertaining the whole ward with silly comments. Among other things he laughed and yelled "WEEEEE, FASTEEERRRRR !!! " while pore tiny "aid lady" was wheeling him toward hospital exit 😆 ! I mean , fun times lol .

I have heard from many that you don't want to do a prostate biopsy under local anesthesia. So I opted for full general anesthesia and the procedure was painless, simple and seemingly fast. My vote it get knocked out and pay for the portion not covered by insurance if necessary

@rick137
When my MRI in 2023 showed suspicious areas my urologist wanted to do biopsies. He said had to do transrectal because my heart failure ruled out doing transperineally under general anesthesia.

I disagreed and contacted my heart failure cardiologist who contacted the urologist and said I was able to do the procedure under anesthesia wihout any significant issue. I then had it done under anesthesia. I felt nothing prior, during or after.

For me stress and anxiety are important to my mental health and I did not want to be under stress and anxiety over having and doing the procedure.

Are you seeing a cardiologist now? If so he/she could give the okay based on your present condition. I too had several procedures under general anesthesia and no issues at all. It was funny for me after I had the biopsies under general anesthesia I had to have a colonoscopy before radiation treatments. When the anesthesiaologist came in he knew me by name and said I just did your biopsies and you did great, not problem for you but I will be there if I am needed. No problem.

I just did not want a transrectal or even transpernia done with local anesthesia. Some will say no problem for them but we are all different. Some like me stress, worry, anxiety over being awake during a procedure like this was not for me. Thus those words you see typed indicate do what is best for you.

I will repeat just in case somebody missed my initial post :

For patients that have health issues or just do not want general a., there is a happy medium

"twilight sedation" !

You will be in deep sleep and not feel anything but will not be "decapitated" by strong chemicals.

Sometimes surgical-centers insist on GA since than they can charge triple amount ! We had to argue with anesthesiologist who insisted on GA and we refused since my husband had sedation the first time around without any issues. Fell in deep sleep and was awake in an hour and out of hospital in 2 .

GA is very hard on nervous system and even can cause delirium and accelerate cognitive decline.

They offered valium but I decided to go with the numbing gel. Yes, I felt a nasty pinch a couple of times but it was over quick. I think there were 12 samples all together. What is a couple ouch when the whole thing was an enormous embarrassment.

A nervous friend of mine had his biopsy while under nitrous oxide (laughing gas). I asked him if he had it done in the dentist office! He did say it worked well and had no pain or anxiety.

I think some posters have hit on this. There is a big difference between general anesthesia and what some posted as twilight. General is usually done when serious surgery is done to bring patient completely out and an anesthesiaologis there administering it.

I have had anesthesia many times. They use a injected calming drug, and then what I am told proponol. I am told most times the patient is awake (slightly) but because proponol has a property of not remembering anything. Just trying to state my experience with this. I have both the proponol level, the laughing gas level, and the deep anesthesia for serious operations where life support is needed when under.

For me I need to have anethsia as have real problems with anxiety and stress. I have heart failure but my cariologist do not restrict me having anesthesia. Your surgeon decides on the level you need. When someone sees anesthesia they can think the deep life support deep anesthesia. There are many other forms of anesthsia that are not at this deep deep level.

Not a anesthesiaist just someone who has had most all of them and my post is my experience with them.

I have had 6 biopsies since 2014. Two - including one this year - were under anesthesia. The rest were without anesthesia. Biopsies without anesthesia are not very painful: but you will just experience discomfort as they take each of the dozen or whatever number of samples. But I do prefer the biopsies under anesthesia even though I can tolerate the ones without.