MRI Fusion Biopsy?

@drcopp Hi, I had the transperineal done at Mayo Rochester in August 2025 without anesthesia. The anxiety before the procedure is the worst part. They give you lidocaine shots to numb, which is, in discomfort terms, equal to or less than getting numbed in the dentist's office. Then they insert the transponder in your anus, and then take the biopsy through the perineum. There is no incision that I am aware of; instead, you hear a noise like a staple gun and feel pressure and a small amount of pain. Each one of those clicks is taking a biopsy sample. There is discomfort, but far less than your mind has built up. I mean, the whole arrangement of having something up your ass and sitting in a weird contraption is awkward but the team was very casual talking about places they have gone hiking and such. Their demeanor brought the whole tension level down. I would call the procedure awkward and uncomfortable, but not what I consider painful. Afterward, I may have had spots of blood but nothing else except it was sore down there. You could definitely tell something had happened for me it was a feeling like being too long on a bike seat. Not anything to interfere with everyday life but I could feel it during bowel movements and such. This all diminished gradually over maybe 3 weeks-----something like that.

@dhasper
When I was working with my Mayo Jacksonville urologist who wanted to do my biopsies transrectal because of my heart failure he mentioned I could travel to Mayo Rochester as a urologist there had developed a procedure to do biopsies transperineally without anesthesia.

You are confirming he gave me good information. For me I wanted to do transperineally and with anesthesia so involved my heart failure specialist who informed my urologist that there was no contradiction of me having anesthesia as my heart failure was well compensated.

I know you did not write your post to me and hope you don't mind me responding, but when I read your post and saw you posting what my Mayo Jacksonville urologist told me about a Rochester Mayo urologist I wanted to mentioned I had heard this being done at Rochester.

@kennyo @jc76
I had similar biopsy experience as you describe--lidocane but no other anesthesia, fairly mild discomfort, minimal after-procedure soreness, perineal version. I'm due for another MRI in February to be followed by another MRI-guided biopsy. I'm fortunate so far--3+3 and 3+4 in 2 jabs out of 23, so I'm on active surveillance. I'm hoping for similar results from the 2026 biopsy!

Thank you all, I am better prepared, as I have not recived the pre-operative packet of info. yet and had no idea what this new procedure involved. I had two usual biopsies prior to this.

@dhasper Ah, memories, cherished memories…I can still see the bulging eyeballs of the 2 oncology nurses staring at my spread-eagled butthole…
Now I know where the phrase “taking everyone’s picture” comes from!😳

@heavyphil LOL......... I remembered after I wrote that summary that about half way through he removed the transponder and told me I needed to try to pass some gas. I immediately farted and the other three in the room applauded. I said I am 66 years old and that is the first time I received applause for a fart. LOL. Yep. Fine memories of that day.

Just curious...why would anyone NOT get general anesthesia for either kind of biopsy? I got the transperineal while knocked out on Propofol. Going through that while awake sounds like a real horror show, even with a local numbing.

@dlwilson
We are all different. For me I concur with your post. Just was not something I wanted to be awake for and having anesthesia drastically reduced my anxiety and stress prior to procedure.

For some anesthesia is not for them. Ohers pain thresholds are different in what they can endure or even feel.

I had the same propofol anesthesia along with other relaxers. I felt nothing prior, during, or after. And if someone had not told me was all over would not know even had been done.