@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.