Unless you really have some medically necessitated need, anesthesia is absolutely not necessary. I know many will say this that you really don’t feel anything, I did not, but you will have others that say opposite. Maybe it’s an individual pain threshold for people. Again I have had more pain from the initial shots for dental work. I had rectal. I can’t speak to perineal. Rectal was quick and easy. just follow the antibiotic regimen before and afterwards and I am immunocompromised with need for IVIG transfusions from a prior cancer twice a year. Now you will also hear how rectal is so much riskier for infection than perineal by the statistic numbers which bear that out, but a 4% to 1.4% to me are just that. You have possibly up to 2% surgical infections on almost all surgeries. My urologist had done hundreds and never seen one. He said in speaking with other urologists, it was more likely in patients that did not follow strict antibiotic protocols and the numbers also statistic numbers include patients that get them possibly in other countries that don’t have the same protocols we have. Yes, they happen, but rarely at any established US practice.