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Prostate Biopsy Complication: Painful Orgasm (Dysorgasmia)

Posted by handera @handera, Jan 9, 2025

Diagnosed in October 2023 with low volume Gleason 3+4, decipher 0.22. Post biopsy PSA’s have average 6.2, compared to 7.8 prebiopsy.

My 12 month mpMRI indicated only the largest of the original three (PIRADS 3, 4 & 5) lesions was visible and it had reduced T2 and DWI/ADC signaling so everything is looking good regarding the MRI and reduced PSA.

It took me more than 2 months to recover from my 1st biopsy (21 cores) and I’m not looking forward to getting another.

Actually, even after 15 months, I still experience a low level groin soreness where tissue scar may have formed, near a nerve, after the biopsy procedure. Nothing major, more of an annoyance and a minor aggravation.

I found out this is a recognized complication of prostate biopsies; especially for those having large numbers of cores taken.

Has anyone experienced this biopsy complication?

If so, how long did it last and did you find anything to alleviate it…or did it eventually just go away?

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Too-Many | @toomany | Sep 7 6:27pm
In reply to @malligood "I’m scheduled for a trans rectal with only lidocaine. I’m freaking out because I had this..." + (show)
Profile picture for Goodvida @malligood

I’m scheduled for a trans rectal with only lidocaine. I’m freaking out because I had this 15 years ago and still recall the discomfort.
I’m considering contacting Mayo Jacksonville. Do they do trans perineal? Any idea how long it takes to get in and get biopsy. I’ve had MRI on Pi Rads 4 lesions

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@malligood Amen! I feel your pain, brother! There are some folks on here that report having no pain or discomfort from it whatsoever, even without anaesthetic of any kind, but I'm definitely not one of 'em. It wasn't 'unbearable' by any means! I think it's mostly a function of how many cores they take, their technique and the equipment used, their experience with it, how deeply they sample, etc., etc. I wish you the very best with it, but I'm confident you'll sail right through it either way.

Would a single 5mg tablet of Lorazepam help beforehand? Or maybe a Vicodin or two afterwards? Do geese go barefoot??

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jc76 | @jc76 | Sep 8 6:22am
In reply to @sandguy "Just want to comment that here at my local university center of excellence, a few days..." + (show)
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Just want to comment that here at my local university center of excellence, a few days before my biopsy they had me come into the doctor's office for a quick "butt swab" (my technical term) for a bio analysis.
I suspect that's just to make sure i didn't have any antibiotic-resistant infection there, which might have affected their choice of antibiotics ( or something...)
The procedure itself, also trans rectal, really wasn't a big deal in my case, really just more some discomfort a opposed to actual pain. I suppose I might have preferred having had fewer that ten or so people in the room, but I guess that's part of it's being at a university hospital.
I just found it a little em-bare-assing.

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@sandguy
They take the butt swipe to do analysis of what antibiotics they should give you prior to your procedure. Thus the antibiotics are directly attuned to your body, your bacteria, and specific to fight infections specific to you.

I had this done on biopsies, and also when they did Space/Oar and markers. So passing on what my urologist and R/Os told me what they were doing and why.

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oldgreenpaint | @oldgreenpaint | Sep 9 8:00am
In reply to @malligood "I’m scheduled for a trans rectal with only lidocaine. I’m freaking out because I had this..." + (show)
Profile picture for Goodvida @malligood

I’m scheduled for a trans rectal with only lidocaine. I’m freaking out because I had this 15 years ago and still recall the discomfort.
I’m considering contacting Mayo Jacksonville. Do they do trans perineal? Any idea how long it takes to get in and get biopsy. I’ve had MRI on Pi Rads 4 lesions

Jump to this post

@malligood My opinion, having had both procedures done……Trans rectal with local only, I felt no pain, just heard the Clicks when samples were taken. Trans perineal under just local lidocaine, again no or very little pain, but many men report otherwise. I would say given your post that you would be better served to find a provider that does trans perineal fusion guided biopsy, under full anesthesia. This is a more accurate way of doing s procedure . You could discuss with the provider the idea of only targeting the suspected areas, which would greatly diminish the number of cores. My brother had this done and it is easier on the patient. I think in time, places won’t even offer trans perineal under local only.

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