How did your TRUS biopsy go?

I had mine under propofol and am glad I did. I woke up covered in blood which freaked me out, but the nurse told me that the doctor who did it doesn't clean up his patients before moving them to recovery. I had antibiotics for a day before and three days after.

I had blood in my urine for about a day and a half. The first time I urinated at home afterward it was VERY hard to start the stream but then a clot came out and everything was good after that. I had blood in my semen for about a week (aka "murder semen").

My prostate was sore for about a day. I used THC gummies for a day since I can't take NSAIDS and Tylenol is the most useless drug ever invented (except for fever). I couldn't bike ride for a week, and no weightlifting for 3 days.

You will get many opinions on this subject of TRUS vs Transperineal biopsies.
But regardless of the differences in pain levels, bleeding or risk of infection, there is one single overwhelming advantage to a Transperineal biopsy: greater access to more areas of the gland.
It’s been established that you cannot simply biopsy the suspicious area of the MRI since that doesn’t tell the whole story, and sometimes trying to access these other distant areas using TRUS can lead to complications such as excessive bleeding, bladder involvement, etc.
If you are really concerned about just the idea of a biopsy in general, my advice (as a layman only!) as someone who had a painless transperineal, fully awake with local anesthesia only (bilateral nerve blocks) is to have the TP done with sedation. You’ll feel nothing, you’ll know nothing, and the results will probably tell you everything.
BTW, if your urologist is resistant - and many of them are since they are trained in TRUS - find another one. It may be the best decision you make. Best,
Phil

I had a TRUS biopsy and mine was MRI-guided. In this process, the person doing the biopsy has the ultrasound imagery with the MRI imagery overlaid resulting in much better targeting. I had a well defined lesion they were targeting plus sampling of other areas of the prostate. Not sure what you mean by a "no concerning cancer lesions" but realize a TRUS biopsy only samples a very small area of your prostate and may well miss cancer areas. I regret not having sedation as mine was painful as hell! If I had it to do over again, I'd opt for a transparenial biopsy with sedation. And yes, ALWAYS get a second opinion from a well-known, respected medical professional who specializes in this field. You'll find that many of the very best in the country offer virtual consults. Best wishes!

I've had two MRI-guided TRUS biopsies - age 66 for the first, 67 for the second. Both times, the urologist indicated that I would be under "twilight sedation," which I understood to mean "conscious, but out-of-it." I was given Propofol, and I was unconscious through both procedures. Woke up feeling fine and walked out of the hospital under my own power. I was on my way home a little over an hour after they took me to the OR. They required me to have a driver (my wife), but I could have driven myself, no problem.

A little blood in my stool the first time I had a BM. Blood in my urine for a few days, but after the first time I peed, it was just a little pink for a couple of seconds and then went clear. Blood in my semen until I had ejaculated maybe 6 or 8 times. They had told me to expect blood in my semen, but I was thinking a little pink, like my urine - but the first couple of times, it was the "murder semen" @scottbeammeup mentions. A little unnerving!

No pain for me. Just a little "pressure" - felt like I needed to have a bowel movement when I didn't. That lasted two or three days.

No antibiotics before or after, but they may have given me some intravenously during the procedure.

@tgregg99 I agree with @heavyphil . Go for a TRANSPERINEAL MRI Fusion Biopsy . TRUS is OLD SCHOOL I'm 85 and both my Transperineal Biopsies were a walk in the park . NO ANAESTHESIA . I sat for 10 to 15 minutes in the side room after - and drove home . Miminal blood in my stool and urine for less than a week - both times , A 16 Core Biopsy .
NOTE : The TRUS ( TRANSRECTAL ) Biopsy is illegal in Norway following the death of a patient from Sepsis . The family formed an opposition group and won their court case to ban this type of Biopsy . The ban is being considered in other EU countries plus numerous Urologists worldwide , are refusing to perform the Transrectal in favour of the new TRANSPERINEAL method .
Following behind , is the newer " REAL TIME BIOPSY " CALLED : AN IN -BORE OR GANTRY BIOPSY ", where you are inside the bore of the machine ( MRI ) when the biopsy is being performed .
Machine cost is slowing the broader coverage of this new technology as is the use of the more advanced MRI Tesla T 7 machines which will replace the Tesla 3 T machines , which had replaced the 1.5 machine .

My husband had total of 2 biopsies in span of 6 years - both were transperineal robotic assisted and also MRI and ultrasound guided. He had sedation, not general anesthesia (last time anesthesiologist insisted that he get general a. but we absolutely refused - WTH ???). I am sure that made bigger profit margin for surgical-center since there is NO reason for that. God help us with this medical system ... He also got one dose of antibiotic during procedure. He spent time in recovery room until he was able to urinate without problems (that was " test" that he needed to pass to get release form ). He had no blood in urine nor in feces and the only thing was some soreness in perineal area for 2 days.

I have had three transrectal biopsies - this was before I was aware of transperineal.

They were uncomfortable but not too painful. I had local anesthesia, though on the 3rd biopsy with a new urologist/surgeon he suggested nitrous oxide, which helped calm me down. I had to pay $125 out of pocket for that. (I had told him that I was "jumpy" on the first two.). At the time I felt it was worth it, but now I'm a bit on the fence if I'd bother next time.

I was fine afterwards for all three and drove myself home on the first two. I could have driven myself on the 3rd but my wife wanted to be there, so she drove.

I don't think they'll keep you overnight and I don't think there's a need to do so.

Transperineal does appear to be the preferred method, though some have said that it was more painful for them. So, it might just be a factor on your pain threshold. Mine isn't very high.

That said, your MRI results seem to indicate that you can wait on a biopsy - but I'm no expert on this. There are so many other factors to consider with PCa. If there's another factor that has you concerned - like family history - then I would proceed with the biopsy.

And I personally would go with transperineal.

All the best to you.

Thanks so much for your feedback!

I appreciate your feedback!

Thanks so much for your thoughts!