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Transperineal vs. transrectal: Which is worse?
In preparation for proton therapy I am having a spacer and fiducial markers placed on Monday. I just learned that it will be done trasnperineal under local anesthesia. My biopsy was transrectal under local, so I would know what to expect if this procedure was also transrectal.
So, my question is how much worse will this upcoming procedure be, both during and afterward, than the biopsy was? Anyone out there experienced both? Just having a bit of anxiety about what I don't know.
Thanks!
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@surftohealth88
I found this additional information for maybe question’s with your physician. Their does involve
safety concerns that include:
Altered Surgical Anatomy due to missing Tissue Plane: During a radical prostatectomy, the prostate is completely removed, eliminating the natural anatomical tissue plane (Denonvilliers' fascia) that normally exists between the prostate and the rectum.Scar Tissue: The healing process creates significant fibrosis and scar tissue in the prostate bed. This lack of a clear boundary makes it highly difficult—and sometimes dangerous—for a physician to safely inject a hydrogel spacer.
Risk of Theoretical Cancer SeedingNeedle Track Seeding: In the case of BCR, microscopic cancer cells are assumed to be in the prostate bed. Passing an injection needle through an area with potential active disease carries a theoretical risk of disseminating tumor cells into adjacent healthy tissues.
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2 Reactions@forresterra49 Ditto. Had 3 markers and SpaceOAR put in place yesterday. My discomfort was anal from the probe. The doctor said I could play my normal volleyball today and Friday, but I had already backed out of today. This was after being told by their staff on more than one occasion that I would be restricted for two weeks from heavy lifting and physical exertion (including volleball). Mixed signals. I will be playing on Friday!
I had both transrectal biopsy (community urologist) and trans perineal biopsy (Mayo Rochester) and both were done with local anesthesia only (I've forgotten, maybe for transrectal they gave me a valium). In fact, Mayo biopsy was done by a Nurse Practitioner.
Neither was a big deal really, no real pain, just some discomfort. Trans perineal was a lot bloodier (whatever you do, don't look back at the operating table when you leave), was a tiny bit more uncomfortable and overall was much more intimidating....but NP and assistants were very calming and reassuring.
For both, just went to my happy place for a few minutes and let the provider do their job, was very glad to have them done so I could move to next phase of my treatment.