Prostate transrectal biopsy

Posted by rockin2047 @rockin2047, Jan 26, 2023

I would be very happy if you can answer a urology question for me. A recent MRI of my prostate indicated one small lesion which had a high probability of cancer and a second one thought to be benign. The PSA number is 3. The urology doctor is scheduled to take biopsies on Feb 7, 2023. My understanding of this procedure is that a biopsy needle is inserted and guided into the rectum and then passes thru the rectum wall aided by the MRI image and Ultrasound Fusion to target the cancerous spot. Once the biopsy samples are collected from the suspected sites what then prevents the cancer cells that are left behind in the prostate to escape and then migrate to anywhere else they want? As the needle is withdrawn after each sample is taken is the needle hole then cauterized? My concern is whether or not there is a risk of the cancer spreading as a result of this procedure.

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Based on my research, I would not recommend the transrectal biopsy. This biopsy has more chances for infection because it has a needle going through the rectum wall. Also, the transrectal biopsy does not allow for biopsies to be taken across all sections of the prostate. I had my biopsy and radical prostatectomy done at Mayo-Rochester. My doctor took samples where the lesions were located and also took random samples throughout the peripheral region of the prostate.
The latest method inserts the needle at an area between the anus and the scrotum, guided by an ultrasound device that is inserted in your rectum. After each biopsy sample is taken, there is an electrical shock, and I assumed this cauterizes the biopsy area so as to prevent the sample from coming out during extraction.
Best of luck with your upcoming biopsy.

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Although I can’t speak to any increased risk of cancer spreading as a result of the transrectal biopsy, I do know that the knowledge gained from the biopsy is invaluable in making a decision about treatment.

My biopsy was performed this past August, yielded a Gleason score of 4+3, with aggressive cancer cells found in 3 of 12 samples. This, along with an MRI, which showed the cancer was contained, enabled my decision to proceed with RALP.

I think that knowledge is power in dealing with prostate cancer; with multiple treatment options available, I want as much information as possible to make an informed decision on treatment.

My prostatectomy was performed almost 3 weeks ago. Recovery is going very well so far. My follow-up PSA test in 2+ weeks will be revealing. One step at a time…..

Good luck whatever you decide to do.

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I don't know about the needle spreading the cancer, but I would stay away from the transrectal biopsy due to infection risks. I had a transperineal biopsy done on 11/14/22 by Dr. Frendl using a local. It was not bad pain wise as he numbed me up pretty good. I had 30 cores taken as I have a larg100 gram prostate and it was MRI guided so he took 5 cores from the area of the lesion. most were 3-3 but two came back 4-3 from the same area. I am currently trying to get a 2nd pathology opinion on the biopsy slides as I have had questionable results from my dermatologist's pathology group, so I do not trust one individual's eyes and opinion. As far as the biopsy procedure as I told Dr. Frendl, if it is between you or the dentist, I will take the dentist every time.

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Doubt it Get it done

send blood to 4kscoretest.com to see if aggressive PC

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Agree with those recommending the trans-perineal biopsy over the trans-rectal biopsy…

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My transrectal biopsy is scheduled for Feb 7th. I've read enough about this method to convince me to not go through with it. One of the Mayo urologists in an article said he does not even do transrectal biopsies anymore due to the risk of infection. I am in the Wash DC metro area, does anyone know who does transperineal biopsy there? Can anyone tell me how long it took to get an appointment for their transperineal biopsy at the Mayo Clinic in Rochester MN ? Then once completed and I've flown home will I be then flying roundtrip multiple times to Rochester MN for one or more treatment/s? Is there a Mayo contact person you'd suggest I speak with?

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I had an MRI guided transrectal biopsy completed last fall and unfortunately even with the standard antibiotic protocol following the procedure, I contracted a bad infection that required four days in the hospital to overcome. So, I definitely recommend a trans-perineal biopsy if you have access to a urologist who is skilled in this procedure. My biopsy ended up as a 3+4 Gleason score and I've elected for a Robotic Prostatectomy after getting a 2nd opinion consultation at Mayo in Rochester. Having an enlarged prostate with ongoing urinary issues factored into my decision. My procedure is scheduled for this week.

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@rockin2047

My transrectal biopsy is scheduled for Feb 7th. I've read enough about this method to convince me to not go through with it. One of the Mayo urologists in an article said he does not even do transrectal biopsies anymore due to the risk of infection. I am in the Wash DC metro area, does anyone know who does transperineal biopsy there? Can anyone tell me how long it took to get an appointment for their transperineal biopsy at the Mayo Clinic in Rochester MN ? Then once completed and I've flown home will I be then flying roundtrip multiple times to Rochester MN for one or more treatment/s? Is there a Mayo contact person you'd suggest I speak with?

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I belive that Johns Hopkins is a recognized center of excellence for prostate cancer.

Main campus in Baltimore of course.

And there are JH facilities in the DC area and outside Baltimore City that provide some of the care that you may need.

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Highly recommend the trans-perineal procedure. Mayo is one of the best hospitals for the treatment of prostrate issues. Recommend you put your trust in the doctors to do the right thing for you. I’m a believer in prayer to help you get through this process. “Thy will be done “ is the mantra that has helped me deal with the uncertainty of what you are experiencing. If the biopsy indicates cancer, the treatment of the cancer continues to improve. Wishing you the best on the journey you are going through.

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I also had the transperineal biopsy at Mayo after having the option of (only) a transrectal biopsy in my home town. There was minimal discomfort and I felt fine driving up to MSP the next morning and flying home. I would recommend that approach, but the urologist/provider must be experienced with that option. Mine was done by a urology NP at Mayo who was excellent in every way. And as bodeygolfer says, prayer is key because we have a Father who loves us more than we can comprehend.

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