Possible Prostate Cancer: Are there side effects of MRI fusion biopsy?

@kpg7121 Transperineal is what you want…although transrectal is still done, it is archaic compared to an MRI driven biopsy.

Transrectal, 12 cores in May 2025. 10 cores were fine. 2 sent me to the ceiling. Felt like being kicked in the nuts. As said earlier, if transrectal, demand max lidocaine. Other than being a little tender sitting, driving home was not an issue.

My transrectal fusion was 3 on a ten scale. Shot hurt the most. )antibiotic). However my drive home was wild. I felt like I had to move my bowels. My bleeding was bad. Bled through my jeans onto my seat. I wish my wife would have been there. Once home(about an hour) I was okay. I had hardly any discomfort and took zero pain pills. My MRI showed three lesions and pirads 3. Thankfully biopsy showed no cancer

@jc76 I have an appointment with a nurse at the Urologist's office on 2/18 for a "Swab" whatever that means. On 2/25 I have to watch an educational video online, apparently to explain the procedure. When I see the nurse I'm going to ask some questions such as which route they are going to use to collect the biopsy because this is the first time I'm hearing about transperineal biopsy etc. I guess it's a good thing that I found this discussion forum.

Had a 21 core MRI-ultrasound fusion TRUS (transrectal) biopsy, under full anesthesia.

You can read details at this Mayo Clinic PCa support group link, along with other comments.
https://connect.mayoclinic.org/discussion/prostate-biopsy-complication/
I now understand my experience to be somewhat unusual, but studies have indicated that it can happen in up to 15% of men having a prostate biopsy.
https://journals.viamedica.pl/sexual_and_mental_health/article/view/33579
I (like you) wished my urologist had fully informed me of ALL possible side effects, even if they are rare.

I think the large number of cores taken, coupled with needles that just happened to hit (and injure) sensitive nerves surrounding the prostate caused my side effects….it is a known and “under-reported” side effect that even has a name in the medical community…. dysorgasmia.

Even so, in my case, this side effect only lasted for 2-3 months and now it’s just a bad memory….

@kpg7121
The urologist using the MRI/Fusion for your biopsies shows trying to use most updated way to do biopsies. However should have explained the procedure.

I had a similar issue but though the same. I saw the schedule to MRI/Fusion scheduled date and contacted my urologist to remind him I have a ICD/Pacemaker and saw using MRI. He finally came back with it is not using a MRI machine it using the MRI to fuse with the biopsies to help guide the biopsies.

Everyone is different but if you want the lowest chance of infection do transperineally. If you want to under anesthesia and not feel anything chose transperineally. If you want the urologist to have the most ability to biopsy the prostate chose transperineally. And yes I had mine done transperineally and unless they had told me when I woke up that is was over I would not even know it was done.

@jayhall I think you're right. I'll have to risk it & have the wife drive me home. Lol

@kpg7121 The instructions I got said I should be able to drive myself home, I couldn't due the pain from the shot. When I have been at my Urology clinic everyone having Biopsies had drivers/escorts. I would suggest that you get an escort/driver.

@kpg7121
That’s it ml and cc’s are interchangeable. They mean the exact same thing.

Your prostate is pretty normal size. The BPH could raise the PSA, but the size of the prostate would not raise it beyond normal values.

I agree with the comments above. I'm due for my second transperineal biopsy next week. My MRI last week was pretty similar to the one I had last year prior to my biopsy. It was uncomfortable but not particularly painful. and yes, blood in the semen for several weeks afterwards. I have a large prostate and BPH which yields a higher PSA score (7.76 recently) but no dramatic increases (no doubling). Your jump from 3 to 4 is not alarming, but merits further investigation as you are having. I'm almost 80. Good luck.