Transperineal biopsy under local; positioning, experience

Posted by scooterphilly @scooterphilly, 6 hours ago

I’m scheduled for a transperineal prostate biopsy under local anesthesia. I’ve read a fair number of posts here, but I’m looking for something more specific.

What I’m trying to understand is what the actual positioning is like: how exposed you are, how long you’re in that position, whether the rectal probe insertion and the time it stays in place is uncomfortable or just strange, and how much control you have to ask for a pause if you need one. I’ve had procedures before, but something about the mechanics of this one, the vulnerability of the position combined with being awake for it, has me more preoccupied than the pain itself.

If you’ve had a TP biopsy with local anesthesia (not sedation), I’d appreciate hearing: How you’d describe the positioning itself, and how long you were in it? Whether the local anesthetic adequately covered the probe placement, or just the needle punctures? Anything you wish someone had told you beforehand about what to expect physically, separate from pain?

Trying to go in with a realistic picture rather than a worst-case one. Thanks in advance for sharing.

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copyman | @copyman | 5 hours ago

Hi, I had the same procedure which is usually done under local anesthesia. It's not that bad at all. Everything is done very professionally. You lay on back with legs up in stirrups. They immediately cover then tape your testicles & penis up out of the way, numb you, insert small probe into anus and insert 2 catheters where the biopsy needle will be inserted to take samples, usually around 15-20 samples. One nurse will stand by you holding your hand and talking to you, trying to take your mind off of it. It is basically painless but what is annoying is hearing the click each time a sample is taken, your mind makes you jump a little. It's over in about 20 mins. Not much pain after. They will have you drink a lot of water after procedure and as soon as you urinate in toilet you go home. Be prepared for some blood in urine & semen for several weeks. The first few times you ejaculate don't be alarmed if semen is bright red blood. This can be a real shock to you and partner! Wishing you the best and good luck on the results being a low Gleason score!

jheadding | @jheadding | 2 hours ago

I had a transperineal biopsy at Mayo. Not just local anesthesia, but also conscious sedation. My question is, are you opposed to conscious sedation or have other concurrent medical conditions that are contraindications for conscious sedation. Basically it’s light sedation, and you will have no memory whatsoever of the procedure. not only do I have no memory of the procedure, but had no pain. The usual drugs used are a combination of Versed, fentanyl and at times propofol.