What to Expect After Your Prostate Biopsy?

You’ll probably get a care sheet from your urologist.  Maybe you found a website with a list of possible side effects on the internet.  Beyond that, there aren’t a lot of reports with personal experiences from a prostate biopsy.  Probably for obvious reasons.  Most guys don’t want to talk about it.  Some are just too tough or too cool to tell it like it really is.  With a careful Google search, you can find some personal experiences on the procedure.  There are even a few horror stories.  If you’re squeamish when reading about unpleasant medical complications, STOP READING NOW!

According to the link above from the Mayo Clinic, here’s the original summary from 2009 of what to expect:

After a prostate biopsy, you’ll probably need to continue taking an antibiotic for a few days. You may feel slight soreness and have some light bleeding from your rectum. You may have blood in your urine or stools for a few days. You may also notice that your semen has a pinkish tint caused by a small amount of blood in your semen. This can last for more than a month.

The first part is pretty much right on the money, in my experience.  It’s that last part that may not be completely accurate.  In fact, a number of respectable institutions fail to mention this issue at all on their information.  Here’s the squeamish part.  A pinkish tint doesn’t begin to describe it.  Initially, we’re talking dark, blood red, as if you have a serious medical problem.  Now, there’s no pain or discomfort involved, the systems works just like normal in that regard, it’s just disconcerting to see it.  Your wife, girlfriend or other woman may not be as sympathetic about this sort of thing as you’d like, given that they have dealt with a similar issue since puberty.  Even so, you should probably consider having condoms on hand and using them.

This may not be the case with all men after a biopsy, but it doesn’t seem uncommon from what I’ve read.  I find it interesting that I wasn’t once told about this possibility and it wasn’t on my care sheet, either.  You’d think they’d at least mention it to avoid getting panic calls from guys who didn’t do a little research before the procedure.  Well, if you’re going for a biopsy, consider yourself warned.  Maybe it won’t happen to you.  I hope not!

Also see my guide for recovery, side effects and complications from my second biopsy, and read the hundreds of comments with personal experiences from other men below.

For those looking for worst case scenarios, like infections or spreading cancer, you can find that too.  These are some of the things that worried me enough to postpone my biopsy in the first place.  Some websites go overboard, perhaps trying to use fear as a motivator to get you to consider their alternatives.  It’s a powerful motivator, but however small, there are some serious risks that should be considered.  For most men, the complications are minimal.  A little pain, some blood and obviously the anxiety of waiting for results.  Nonetheless, I think patients should be made aware of all possible risks so they know if they need medical attention or not.

Originally published Mar 9, 2009. Minor update, March 9, 2019.

576 thoughts on “What to Expect After Your Prostate Biopsy?”

  1. See it has even affected my ability to read the calendar! My latest post should have said ‘spoke to soon on JANUARY 9TH’ (not 11th).

  2. Seems I spioke way too soon on Jan 11th!!!

    I deveoped a prostrate infection the very next day and have been really ill since. Loading up with anti-biotics from the hospital (at cost of course) but if the biopsy is negative then that’s it…no more! I will take my chances because, believe me, an inflamed prostrate is not a fun way to go.

  3. well I had the biopsy today (6 hours ago) and I can say it was easily the worst 30 minutes of my life. I do believe I actually may have passed out during the procedure since I do not remember one song playing on my ipod ( I brought my music and headphones to blare so it would drown out the “popping” noise everyone else had talked about). That combined with me remembering them taking only 6 “samples” when they in fact took 12, leads me to believe I had literally shut down for a few minutes. Regardless, I made it through and will recieve results in about a week – although the doctor seemed very comfortable in telling me he saw nothing out of the ordinary on the video. I would highly recommend anyone bring an ipod or something to drown out noise BUT I can also tell you what I told the doctor: I will never have another one. I even told my wife how much I loved her but that I would prefer to stick my head in the sand before I subject myself again. When the medical community is willing to treat this like a colonoscopy and offer sedation – that’s another story. As of now, that is only a last resort and many insurers will not pick up the cost of the procedure and/or force it to go toward your deductible first (unlike a colonoscopy). In any event, I now am enjoying the soreness of my rump, the constant need to go #2 and when I do need to pee, the cute little blood clots that find their way through my stream. Sex: That willwait a while. I told my wife she will get plenty of sleep for a while. In a touch of irony, the song playing on my ipod that I do remember: “Waiting For the End.”

  4. going thru my first biopsy in two days. Very apprehensive b/c of course I don’t think I need it and have been putting it off for a couple years. My PSA has crept up from 2.45 about 3 years ago to 2.9. I am 46 years old. I am going on the assumption that I have BPH/enlarged prostate at most. The info on the web is helpful but also very unnerving. Not sure what to expect but I know discomfort will be there. I am planning on taking in an ipod and blasting the music so I don’t hear anything. If it comes back negative for prostate cancer, is there anything i can insist upon to make sure the PSA level does not continue to climb? In my mind, I am doing this once and that’s it! If i have cancer, I will get that removed and go from there and be glad I bit the bullet to have this done. Any advice on lessening the pain that I am expecting? My doctor said I basically have about a 10% chance of them finding anything cancerous due mostly to my age but it’s better to have it done now than regret it later. (Sigh).

  5. BAD EXPERIENCE
    I had the usual prostate biopsy done over a year ago, my PSA was 8 and going up. The worse decision I ever made was getting a prostate biopsy. I bleed red not slightly pink for over 4 months. It took over 6 months to clear up. My Dr’s said that could be normal. Now it is painful for me to have an orgasm and the amount of semen is 2/3 less than befor the biopsy. The results were negative with 18 samples taken. I just had my PSA checked last week and now its 19. Recommended another prostate biopsy….NO THANKS. I had a quadrouple heart bypass done 10 years ago. I would much rather go thru that again than another prostate biopsy.

  6. Had my first prostrate biospy in April 2010 when PSA was 4.34. Came back negative. However, PSA has kept rising slowly and is now 6.2.

    Hence, just had second prostrate biospy this morning (two hours ago) and, naturally, will await results with a touch of anxiety!

    The biospy is not as bad as you fear. The insertion of the probe is the thing I found the most uncomfortable but the biospy needle was just a slight jolt which gave me a shudder and that’s all. I think the Dr only took 9 samples because I was counting but he wasn’t. But, is one sample more a big deal? Too late now!

    Did not even notice the anasthetic needle – and I took no relaxants beforehand etc, and went to the hospital on my own.

    Last time the blood in urine and semen was fairly light but not at that point yet so can’t say but backside feels OK so far.

    In my view, there is much scaremongering on the internet about prostrate biopsies and this should not put anyone off having one. Better to know you have a problem than find out way too late. (Based in UK)

  7. As I promised here I am, back with the results. First of all after the biopsy I had blood in my urine and semen for about 10 days. The blood is dark in color, therefore, it gives you the impression that it is the old blood from the biopsy and nothing new. There is no after-pain associated with the biopsy. They took 18 samples from my prostates and the result of one sample was positive for cancer although it is confined to inside the prostate. I have been doing research and reading all available options on how to treat it. I have seen a Radiologist/Oncologist and I am about to see a urologist surgeon as well. I will decide on what course of treatment to follow soon. I will report on my experience and in the meantime feel free to contact me with any specific information that you may want.

  8. 11 days post biopsy, good strong orgaism mostly blood though!! I had a cystoscopy scope of bladder then a prostate biopsy (2 for 1 sale) back to back. The biopsy was only painful due to the urge to pee. My current complaint is having a sore rectum, prep H helps. Constipation is excruciating!!!! Taking stool softner. DX T1c, 4.8, leaning towards Cyber Knife. Read three books so far, PCa for Dummies, (simple primer easy read) Invasion of the prostate snatchers,(this book will help you understand PCa is a business and we should always get 2nd and 3rd opinions.) The decision:Your prostate biopsy shows cancer, Now what? By John C. McHugh.(A uroligist with prostate cancer, providing, honest, humorous experiences) my favorite book because of the dispelling of myths. Like PSA’s are worthless!

  9. Hello guys,
    This forum has been extremely helpful to me. Im 41 and had a psa level of 4.5. I had a biopsy 3 weeks ago and while slightly painful, i have little children that need me so it was necessary. No cancer found but they mentioned precancerous cells so i have to have another biopsy in 6 months. Im not looking forward to that at all. I too experienced the brown semen and it is scary. I find comfort in knowing that this is normal. Thank you guys. Good luck to all

  10. My problems were resolved in less than 2 hours post biopsy.
    This is my second one: For peace of mind reasons. I think it will be negative, but one never knows. According to stats if
    you have a negative biopsy first time around,you still have a
    22% chance of having a positive biopsy. Remember 78% are great odds. It depends on how skilled your Urologist is. Mine is fast,clean and accurate. No blood in urine, no blood in ejaculate no blood in stools. Tylenol immediately post biopsy was all I needed. Sure the biopsy itself was painful and uncomfortable with a small diameter broom stick up you ass, but nevertheless, not a terrible experience for me. Good luck to all my male counterparts out there.

  11. I’m 68 and had my third biopsy (PSA 14) on August 31, only this time it was under general anthesia. (Findigs were negative.) I had the normal after affects, new and old blood in stools, urine and ejaculate, etc. However, I did notice that post procedure my ejaculate became very runny and yellowish, and continues to be so 4 months later as opposed to thick and creamy prior to the procedure. Has anyone else experienced similar symptoms?

  12. Had a biopsy about two weeks ago, everything went well. A week after the biopsy I was unable to urinate and had to go to the urologist to have a catheter put in. I went back three days later to do a bladder void test which necessitated putting the catheter back and to top it off I am having issues with my bowel movements and pressure on my rectum, I’m not sure if these are issues that will hopefully resove themselves. Anyone had similar experiences or have any idea what is going on?

  13. I have han high Psa readings for the past 9 years at 8.9 14.1 12.6 14,4 15.1 20.8 19.4 average has been 13.2. Had first biopsy 1n Sept 2003 no pre anesthetic just straight in with 12 needles,blood in urine stools for 10 days, no real discomfort afterwards blood in semen when tried couple weeks later. Result negative. Because Psa remained high when at 20.8 in Jan 2009 second biopsy, this time first needle aneasthetic felt all 12 needles but no pain bit dicomfort. Blood i urine 2 days, brownish semen when tried 2 weeks later then back to normal, test negative. In Dec 2009 Psa still high at 17.25 third biopsy, no problems discomfort only. Blood in stools for 2 days but in urine nearly 3 weeks, semen small amount and light brown, now 2 years later semen (once a week) still small amount but still light brown, no discomfort on discharge but pleasurable sensation now gone’ In July 2011 still Psa at 19.4 Doctor then Specialist recommends another biopsy,arranged but then I decided to cancel and just have Psa test every 6 months. Currently at 18.6. I am 79 years of age, hence the once a week mentioned earlier’ So over the years with very high Psa readings throughout and 3 biopsys all negative with no change at in health or symptoms associated with enlarged postate which I do have, I wonder just how reliable Psa tests are. I understand that there is now a more reliable urine test avaiable. So for those readers who have high Psa readings I would not worry too much as Im sure there must be others reasons for high readings other than cancer. At my age I now accept what will be will be. Good luck to you all.

  14. If neophytes to the biopsy process do not get an idea of what it involves from what has been posted here, it’s either narcissism or avoidance.

    Moving on from here the real question is what to do given the diagnosis following biopsy. It’s one thing to fear the process, another to deal with the result. I’ve been there and done that. I have prostate cancer. Let’s talk about how to deal with it.

  15. My apologies for a long commentary. A little background first. I am 60 years old and very active physically. I play soccer 3 times a week and do other physical activities 3 other days during the week. I had a PSA level of 3.7 about 3 years ago which made me see my Urologist. After a finger examination he felt a node that had to be checked and he scheduled me for a cystoscopy. The result of that examination was negative and I was told to keep an eye on the PSA level. The following year the PSA level dropped to 3 and then to 2.7 until October of this year where all of sudden out of nowhere it went to 5.1. A follow up exam and a second blood test in November of this year revealed the level of PSA to be 6.4. The Urologist scheduled me for a bladder capacity and urination flow test followed by a biopsy which was done last week and I am still awaiting its results.
    For the biopsy I had to take Cypro from the night before. I was told to have a light dinner the night before and use 2 Enemas one the night before and another the day of. Also, I was told not to drink water or any other fluid at least 8 hours before the biopsy. I went one step further in all of these instructions and had no dinner the night before and no fluid for 18 hours before the procedure. I used the Enemas as instructed. I was asked about any type of medication that I take regularly. My answer was no prescription drug, but I take fish oil, multi-vitamin and Glucosamine on a daily basis. That was fine and the point here is to avoid taking any aspirin or blood thinning medication at least a week before the biopsy. I opted for the total anesthesia as it is totally painless during the procedure.
    I knew the type of the procedure was to penetrate through rectum and I knew that there would be a penetration through the wall of the rectum into the prostate to get samples. Therefore my concern was more about the possible infection than the discomfort. Although any type of surgery has the risk of infection the risk in prostate biopsy is not any greater because of where the penetration occurs. It is recommended to take at least 12 samples. In my case the doctor did that. It is also recommended to NOT mix the samples for the purpose of culturing. The accuracy of where the sample came from can isolate the exact point of malignant cell and might enhance the treatment. Although in my case the doctor used 6 jars and mixed every 2 samples into 1 jar. My next concern was as to when could I resume my physical activities. My doctor basically told me to wait at least couple of days. The other concern I had was if I could urinate right after the surgery. This concern was due to a bad experience when I first did a cystoscopy 3 years ago. I could not urinate then and had to have a catheter for urination which was very discomforting and somewhat painful.
    The biopsy as I mentioned above was painless since I was totally out. It took me about 30 minutes to recover from the anesthesia and at that time I felt a very dull pain in my rectum that was totally unbearable. I asked for a pain medication and received a half dose of some fast-acting pain reliever medication that helped a lot. I asked to go to the bathroom to urinate and I tried to no avail. The doctor said because of the anesthesia it could be up to 6-8 hours before I can urinate. I was driven home right after that. At home I tried to urinate and I was successful. The urine had some small amount of blood. The blood in the urine lasted 1 more day. I went to work the next day (office job) and actually went out to play soccer 2 days after the procedure. Today, a week after the biopsy, I noticed some small amount of blood in the urine again. I have been drinking water a lot to flush out anything left in there. I have not had the nerve to ejaculate yet and I am not looking forward to go through the experience of seeing blood in my semen.
    I have been doing some research as to what could have caused the jump in the PSA level in my case. Once again, by way of some background, I started taking 5 Hour Energy drink about a year ago to the tune of 1 small (couple of oz) bottle a week. About 3 months ago I switched to an 8 oz can of Red Bull energy drink, once a week. Both of these products are high on Vitamin B and particularly Vitamin B12. I came across this article on how B12 can promote prostate cancer. http://www.psa-rising.com/eatingwell/vb12_folate04.html. Here is an interesting paragraph from this article. “But in fact, increasing plasma levels of folate and vitamin B12 were statistically significantly associated with increased prostate cancer risk, with an odds ratio of 1.60 for folate and 2.63 for vitamin B12 for highest vs. lowest quartile. “
    I could not find any information on either of these 2 products as to their harmful side effects. Although I am speculating here, I am wondering if the theory of vitamin B12 and prostate cancer has any merit. Although my intake of these 2 products is so minimal that makes me want to dismiss any harmful effects.
    Currently I am waiting to hear the results of the biopsy and will post again to let you know. As for the effects of Vitamin B12 I would like to hear from anybody else whom might be able to shed some light on this. Any opinion by a doctor is most welcomed.

  16. Had my first biopsy a week ago, 10 samples, had a PSA of 6.4 which necessitated the biopsy. I was very nervous about the discomfort of the biopsy but it was a non-event. The only uncomfortable part was the ultrasound probe. I didn’t feel biopsy part at all. I wish I had known this before hand as I had read about this being ultra-painful. The results were positive for cancer on 6 of the 10 samples. Gleason score of 7. I am in the process of deciding robotic or open, but am leaning toward robotic. This whole process, from the time I was told to now has sent me into a tailspin emotionally, which I suppose is common. Trying to stay positive, but finding it very hard. Good luck to all who are going through this.

  17. I’d like to clarify my incredibly [sorry] long post above:

    My plan is to ejaculate once a week from here until there is no more blood in my semen not because I have this unbridled urge to ejaculate, but rather because it seems prudent to try and get the blood out of my prostate, as others have commented. It makes sense to me that old, brown blood should be purged, while allowing time to heal in between ejaculations. I’ll adjust this therapy plan as results warrant.

    As a minor correction, paragraph 9 should read “I haven’t had blood in my urine since the first week” and not the reverse.

  18. I got some good insights from these comments, so I thought I’d add my experience, too. I had a prostate biopsy 2+ weeks ago. I was given Cipro 1 hour before the procedure, and for 2 days after in order to prevent infection. The needle used does take bacteria into your prostate, but Cipro is powerful and accumulates effectively in the prostate, so the bacteria is dead within the first 24-36 hours. It works well; no problems with infection.

    I’m 54-years-old and after my PSA went from 3.9 in 2009, to 6.4 in 2011, and subsequently back down to 2.7 two weeks later, the doctor suggested I have a biopsy.

    I was anxious, and only more so after Googling “prostate biopsy”. All the uncomfortable details (e.g., needles in your rectum), and the horror stories (e.g., guys vomiting on the table because of the pain, etc.) I wondered what I was in for. There was no question in my mind that I’d have it done, because my father died of colon cancer which probably could have been prevented with screening. I didn’t want to go out that way.

    Well, the procedure went well and was not painful. I think the worst part is the pre-procedure anxiety and “what if’s”. On a scale of 1-10 the actual procedure was a 1. No kidding. The most uncomfortable part was having the probe inserted. My anus said “No!” which was the cause of the discomfort. When I convinced my anus that it would be better for all of us if he would just say “yes”, he relented and the probe slid in without further discomfort.

    The doctor was gentle (never thought I’d be typing those words) and maneuvered the probe to inject the colon area with lidocaine. I don’t know if he actually stuck a needle in the prostate or what; I didn’t want to ask, although now I’m curious. He then proceeded to take 10-12 samples. I lost count worrying about if it would hurt or not. There was a slight click of the probe, and the mildest of pricking sensation. Honestly not bad. It didn’t make me flinch or grimace. My experience was “this isn’t bad at all”. I was even cracking wise with the doctor.

    Then it was over in 5 minutes. Quick; no horror story; no insufferable, agonizing pain. It was mostly anxiety and the embarrassment of having my butt and prostate violated in that way. But even that was all in my head. These folks do so many of these things that they’re waaay past any embarrassment.

    I was given the spiel about a little blood in urine and semen and smiled and left feeling good.

    The lidocaine wore off about 20-minutes later, and I developed a heretofore unknown ache in my perineum area. It worried me because it got up to about a 2-3 on the pain scale. Certainly not bad, but with the thought “I hope this pain doesn’t get worse”. I went home, took a Tylenol (don’t take aspirin or any other pain reliever that may thin your blood and cause too much bleeding), and took a nap. When I woke many hours later the pain was gone and never returned.

    When I next urinated there was a small amount of blood that came out first followed by regular urine. It went on this way for about a week. Sometimes more blood, sometimes less or none with no discernable pattern (it didn’t follow a linear pattern of ever decreasing blood; it bounced around as to the quantity of blood day-to-day). I haven’t had urine in my blood since the first week.

    I wondered when I could next ejaculate. This was the most frustrating part for me, because no one mentioned it, and I had forgotten to ask because of the initial anxiety followed by the relief that the procedure had gone well. I could have smacked myself for being so clueless as to not have asked the one person who could have told me.

    Anyway… I turned to the internet to find the answer, but it was a desert out there; no usable answers; as if no one ever had that question before. When I actually did find some fleeting answers they were at odds with each other. One site in India said 1 month. A doctor’s site in the U.S. said a week. Others said “whenever”. I chose 1 week. The next day seemed way too early for my pin-cushioned prostate, and 1 month seemed both overly cautious and not realistic.

    I masturbated a week later. (Sorry guys; we’re all men here. I know you want me to shoot you staight, so I’ll say it like it is.) I masturbated with the overriding and expressed desire to see what this “blood in the semen” thing was all about. My junk worked fine. No odd sensations or pain or anything like that. I was relieved… until I saw my ejaculate. It wasn’t tinged pink. It wasn’t slightly bloody. It looked like it was all dark blood. Like a horror movie. It was a mess. I’m sure there was semen in there but the overriding sense was that it was all blood. It wasn’t bright red thought, as if it was fresh. It was dark like steak sauce (Sorry. I’m shooting you straight.)

    Well I got back on the internet and found out that’s how it is for a lot of guys. It would have helped if the after-care sheet I got at the hospital had mentioned that instead of sugar-coating it, in my opinion. We’re not children, afterall.

    Anyway, against my better judgement, I flogged my junk again the next day with the hope that I’d cleared out all the blood and was on my way back to the old days. No such luck. It was a repeat of the day before.

    It’s been 2+ weeks since my biopsy and I’ve decided to give my prostate a break. My plan is to ejaculate once a week to gauge my progress while giving my prostate time to heal in between.

    I’m sure it will turn out okay blood-wise. Everyone who’s been through it says, “Yeah, you’ll have that”. I got my results back after a week and they were negative, thankfully. I think my PSA readings are sometimes high because of an age-related enlarged prostate, because I have had the weak stream, dribbling thing going on for several years.

    Have the prostate biopsy, guys, if it’s recommended. It’s not that bad. You have to figure that you’ll mostly hear the bad stuff on the internet, because that’s where everyone goes to complain and vent. You hardly ever hear from the 95% who have had few issues, like with my procedure.

  19. Fortunately, my doctor advised me that I’d have blood in my semen for up to a month following the 12 needle biopsy.

    I did a lot of research online prior to the procedure, and based on what I read, mine was better than I was expecting.

    Only felt the two numbing injections, thank God. The 12 needle biopsies were just the snapping noise and vibration from the device.

    Had hoped for a call with results by now but know I’ll get the word within a few days.

    While the doctor told me to expect blood in semen, and to abstain from orgasm for 7 days, I was still taken back upon seeing the results on the 8th day. Darn red / brown and not comfort looking. Understand that this will eventually clear but more orgasm’s are needed to clear this out.

    So – don’t be shocked guys – it will not look good but it’s part of the process, which is better than ignoring high PSA’s.

    FYI – 61yo, last years PSA 1.55, this year 4.40

  20. I was among the many that had a strong red bloody semen after the procedure. The 2nd time it was a dismal brown.
    I only wonder how long it will occur, but my test was not as good as some above, I do have prostate cancer and now, NO MATTER WHAT THE SIDE EFFECTS, I work to make sure all men I know get the PSA and if necessary the biopsy.
    I will have the surgery to remove my prostate and lymph glands in 4 weeks and cannot wait.
    Think of me, but never decide to not have the test

  21. Darren:

    I agree. But there is some correlation between subsequent biopsy, and upward sloping or radically increasing PSAs and a finding of cancer. This was my case. As of now biopsy is the only method of determining the degree of cancer per the Gleason summation, although MRI’s are now quite good at locating and characterizing the size of the tumor.

    I recommend Johns Hopkins “white papers” on prostate cancer detection and treatment. The most recent notice uses a slightly different approach to treatment, depending on a correlation of diagnostic findings. For example, a finding of a Gleason 6, and a single digit PSA would suggest Active Surveillance, while a Gleason 7 and double digit PSA would suggest IMRT, seeds, prostatectomy, etc.

    The literature on prostate diagnosis and treatment is cutting edge and new approaches and therapies are around the corner. Before I jump to any therapy I intend to get a second or even a third opinion, given my Gleason 6 and an MRI finding of a “small” tumor, confined within the gland capsule…..even with a PSA of 18, then 11.

    Quality of life is important to me, and I’ve paid attention to posters who have been through surgery and radiation, with results that I frankly do not wish to invite unless absolutely necessary to save my life. A finding of prostate cancer should never be ignored, but there are options available, such as active surveillance, to those who “qualify” that should not be ignored despite a finding of cancer. FWIW, it’s just the beginning of the fight.

  22. Don G,

    The problem is that PSA is turning out to be a weak indicator of prostate cancer. In reality, it mostly tells you that you have an enlarged prostate that can be due to a number of causes.

    A prostate biopsy is theoretically 100% accurate when the results are positive. The problem is that a negative result can still mean you have an untreated and growing cancer because it inherently produces false negatives.

    We have a state of relatively poor diagnostics for a cancer that tends to be very slow growing and less dangerous than other cancers. Hopefully, research will produce better tests that do not involve simply checking PSA levels or taking random pot shots with biopsy gun.

  23. DG,

    How else would prostate cancer be found? I for one am very grateful for it otherwise I would be sitting here with an untreated and growing cancer. Ignore it at your own risk!

  24. My PSA went from 2.3 to 4.5 to 6.0 to 10.0 in two years. When it reached 4.5, I was scheduled for my first biopsy mostly because of the velocity. The result was benign, but I had blood in my urine for a month and dark bloody semen for between three and four months. This was much longer than I had expected given what I was told.

    After my next check-up, nine months later, my physician told me I had a PSA of 6.0. I asked if we could test another sample and two months later my PSA was 10.0. So I was scheduled for another biopsy, but the urologist couldn’t see me for three months. Over the course of those three months the government issued its recommendation against using the PSA test. I went ahead with the biopsy after three-months of worry. The results were again benign. But the biopsy itself was very painful. When the tube or device was inserted, no painkilling agent or lubrication was used. This was done so roughly that there was an unusual amount of blood. The first three of the four numbing shots were also somewhat painful. But the anesthetic lessened the impact of the twelve core samples. It’s been two weeks since the last biopsy. The intense ache that resulted from the procedure was mostly gone by that night and for the first week, there was almost no blood in my urine, but since then blood the color of watered down wine appears about half the time.

    It’s important to realize that a PSA of 10, even with rapid velocity, does not indicate the presence of cancer. It may result from chronic inflammation due to a variety of factors ranging from sitting down for long periods to not urinating promptly when feeling the urge to sexual activity. It’s frustrating that physicians tend to recommend a biopsy due to these numbers when other causes may be in play, but I suppose they have to in order to avoid litigation.

  25. Hi Don,

    I had no problems with urinating, in fact the hospital made me drink plenty of water and ensured that I had urinated before I could leave. I reckon you will be okay pretty soon. Bowel movment may take a little longer and that may be a little sore for the first time.

  26. Had the biopsy done hours ago. I expected the blood in the stool, urine, etc., but was not expecting being unable to urinate or have a bowel movement. I am uncomfortable and worried.

  27. Many thanks guys,
    You do feel a bit on your own when this all happens and so I do appreciate your comments, advice and well wishes. I have read a little about the Kegal exercises and will get into that as it appears it may help in the long term. Not sure about the Calais, have seen a number of guys writing about it, but is that available in Australia and is it something that can mess with your heart I heard that some of these things can bring on heart problems, I assume that it is designed to aid erections?
    Once again many thanks for all your feedback.
    Dave

  28. Dave,

    I’m 62 and I had my prostate removed (perineal prostatectomy) on Oct 5, 2011. It’s been about 7 weeks since my operation and I’m still experiencing some incontinence. It seems to be getting better every week. I’ve been doing Kegal exercises for the last 4 week and they seem to be helping. I wore Depends for about three weeks and now I just wear pads during the daytime. I never did leak at night.

    As far as impotence goes I’ve been taking Cialis (2.5mg) for one week and no erection yet. My Uro prescribed cialis daily for 6 months but my insurance company will only pay for 6 pills per month at $8.00 per pill which is way to expensive for me. Cialis offers a 30 day free trial when you apply for a voucher online which I did. I’m checking into online pharmacy’s to see if I can find them any cheaper.

    I drive a bus for the elderly at an assisted living center and I was off work for 5 weeks. I transport a lot of wheelchair people and I wanted to be sure I was healed before returning to work.

    My pathology report came back clean and my 1st PSA after surgery was less than 1 so I’m cancer free for now. I go back for another PSA test in 3 months.

    Hope this helps, Good Luck

  29. Dave

    I work out of my house so it wasn’t a problem for me but I wouldn’t think it would be a problem at work. You will be wearing a pad til it corrects thats all. Just a note – there is the possibility that the operation will not get it all. You will find out in the pathology report a week after the operation. Unfortunately they didn’t get all mine so its on to step 2.

  30. Thanks Ron,
    I hope it will all goes well, it is obviously better to get it fixed and get on with life. There is still a lot of living to do with the family and grandchildren who are really a light in our life. We also both still work so I need to get up and going as soon as I can. How long were you off work and did the incontinence cause any problems there?

  31. Dave,

    I am 53 and had my prostate removed 9/20/11. The surgery is really not too bad. The catheter is another story. No pain but a very weird visual. After removal about a week later some soreness but again not too bad. The incontinence in the beginning was really bad but at this point 2 months later is all but gone. Now the impotence is another story. I have been taking cialus 5 mg every day since the operation and bought and tried a pump but nothing yet. Hoping over time this will improve but it really is the worst part of the surgery. Best of luck. Let us know how you do!

  32. Thanks Raymond T.
    The head has been spinning over the last few days, fairly nervous about the process. I have been perfectly healthily and this was picked up on a routine PSA check. Yes certainly had the anti-biotics only one course used, due to some weird and uncomfortable side effects (they don’t tell you about) but all clear and on infection from the biopsy. I know it is important to keep a positive approach but it isn’t always that easy. The (my) urologists is good but sometimes don’t always have that reassuring touch, and I was embarrassed to ask him some questions in front of my wife.

  33. Dave: Men who have posted here have had ejaculations even one day following biopsy. Many doctors recommend waiting one to two weeks. But the short answer is no. You will not harm your wife or spread your cancer. The worst is the visual. There is a possibility of prostate infection, however…and I assume you were given a course of anti biotic before the biopsy and for a period after.

  34. Hi,
    I am 61 and had the biopsy last week (9 days ago), they found cancer and are going to remove the prostate and associated area in 6 weeks. The procedure was well done with little or no pain experienced, under a mild general. After surgery I do have concerns about the after surgery incontinence ( I understand short term), and impotence (bigger problem). After reading the various posts, I had similar effects and all but the ejaculation symptoms have gone (still a dark bloody color). Can anyone tell me does help or damage, to clean out the pipes, so to speak. Can I cause any harm to my wife or can it spread the prostate cancer. This possibly sounds like really strange question, but I am trying to deal with a bit a the moments. Would appreciate advice.

  35. I’m 54 yrs old, had quadruple coronary artery bypass graft January 2010, so have regular 6 month checkups with my primary care physician. In January 2011, PSA was 1.96, in September it was 4.07. They did a follow-up PSA in October to check that, and it had risen to 4.7. Not liking the velocity of the rise, was sent to a urologist who scheduled a biopsy done 11/18. Was given Cipro to start the day prior to the biopsy. Took two Valium and a Vicodin an hour and a half prior to the procedure. No other meds day of procedure. Uncomfortable, but not really painful. The actual taking of the specimens felt weird, kind of like a staple gun was going off up there,, but it didn’t really hurt. Slight reddish tint to first urination, nothing since then. No bloody stools, but I don’t have solid bowel movements, only a liquid discharge, so it’s tough to tell. First ejaculation was bright red with blood, seemed more blood than semen, not painful. Just tried again for a second ejaculation, and it was still mostly blood, but a brownish or rust-colored blood as opposed to the bright red of the first. Slight discomfort post-ejaculation, but nothing major. The reason I was interested in what a second ejaculation would look like was because I got the results of the biopsy today … all twelve specimen samples were negative – cancer-free!

  36. I did a PSA biopsy November 15th, 2011. First day after the procedure was a peace of cake, however, I got up the second day in a pool of blood very where on the bed, I have been told its ok, there is no pain what so ever and no difficulty doing number one nor two. I have a follow up appointment on Monday November 21st, 2011 to review the result.

  37. To the doctor “UP” who just posted above.

    Thanks very much – it’s always good to get more information like you have provided.

  38. I am not a patient, but a doctor who performs prostate biopsies on a weekly basis and have done so for many years. The blood in the semen is a common event and as detailed in this blog, can last many weeks. This naturally freaks out most men. I always warn my patients about this and advice the use of condoms. I also tell them that unlike in the urine/bowel motions, blood in the sperm can look unusually fresh and bright red. This is not because the bleeding is continuing, but due to the presence of citrate in the semen. Citrate makes up about 5% of the semen volume, but more importantly it acts as a natural anti-coagulant and this accounts for the brightness of the blood in the semen. I hope this information will be reassuring to the users of this blog, because although we have made inroads in the acceptability of this procedure, it unfortunately does still come with a level of unpleasantness.

  39. Bryan: You may want to ask your doc about having an MRI. It is an excellent tool used to locate tumors and does not involve radiation. As such, there is some acceptance for using it in an AS (active surveillance) program instead of radiation/surgical therapies.

  40. Bryan: You and I are in the same condition. Gleason 6. I’ve had excellent results with CT scan (no metastasis) and the MRI confined the tumor to the right hemisphere and described as “very small.” I’m in no hurry to select a therapy and have researched what is available.

    Your description or radiation (photon) therapy sounds like IMRT…relatively medium doses administered about a 7 week period. The results of IMRT are about the same as radical prostatectomy over time…that is about the same life expectancy and about the same effect on erectile dysfunction and incontinence. This is the counseling I received from the urologist…not my opinion.

    If you have a slowly progressing cancer, like i do, please do not rush your decision making. Get a second or third opinion. My own research, which I only confirmed with my urologist last week was that my options were either Active Surveillance…meaning rigorous monitoring annually without therapy…and CyberKnife therapy were the best options. But there are more options out there that should be explored: Proton therapy and brachytherapy-the planting of cancer destroying radiation “seeds”…which has very effectively controlled the cancer.

    If I were to undergo a therapy now, my choice would be CyberKnife. It positions the administration of photon radiation more precisely than IMRT and it is administered in higher dosages for about 4 days/45 minutes only. It is not routinely recommended because it has about a three year track record, but the results,, especially regarding minimizing ED and incontinence are encouraging.

    Lastly, doctors recommend what they know and specialize in. Some specialize in DaVinci, robotic prostatectomy, others in IMRT. Loma Linda, in CA, specializes in proton therapy ..others in brachytherapy, and finally, in CyberKnife. PLEASE do your research, ask hard questions, especially on the consequences of the therapy on quality of life issue (ED and incontinence). And DO NOT rush into the decision making if your cancer has been identified as slow growing…like a Gleason 6. I happen to be a healthy 72. And I know from studies that I am more likely to die from other causes…65% over the next 20 years if I do nothing at all regarding my prostate cancer.

  41. Just got the results of my biopsy. Not good. Fortunately cancer in early stages. Doctor recommends radiation treatment for 5 days a week over a period of 5 to 6 weeks. At this point of the procedure my wife and I are maintaining a positive attitude but uncertain what the results of radiation treatment might be. Anyone had that treatment? I’d appreciate your thoughts.

  42. Age 57, PSA 8.8, biopsy on 11/10/11, done together with a “green light laser” procedure from the other side. I had something they called “twilight” anesthesia, and don’t remember anything from getting on the OR bed to recovery. Am taking Cipro and will continue for another week. Don’t know how much of my symptoms are due to the biopsy and how much to the green light laser.

    Initially I had blood, and clots in the urine; the stream was very weak and irritable (burning sensation), and I had to go every hour or so. Now after 60 hours, the first two or three drops are still quite pink; it still hurts to pee, but not as much. Still need to sit down and the stream is still weak. Still need to wear a pad since there’s slow pinkish oozing.

    The one point that I haven’t seen elsewhere is that I haven’t had a bowel movement since the pre-biopsy enema. When I try hard, a drop or two of blood/urine comes out, and I’m waiting for my urologist’s recommendation. Not even thinking about semen or anything in that area.

  43. Had my biopsy on October 31st, 2011, I am a 64 year old male.

    I found the worst was the insertion of the instrument, as it felt like a truck was being inserted.

    I was not bothered by the local freezing nor the 8 samples taken. The whole procedure lasted about 10 minutes and I was dressed and on my way back to work.

    I found no blood in my stool nor in my urine and no discomfort in doing either.

    The shock if i may call it that was today while the wife is shopping, I decided to masturbate and I must say what came out of me was a surprise. It looked nothing like semen and a lot like darkish reddish brown substance. Glad I cam on here to check side effects.

    I have yet to receive the results of the biopsy so will patiently await that call.

  44. Age 68 Had my third biopsy two weeks ago after PSA reached 17. (I live in New Zealand). Over the last 10 years I’d had 2 other bio’s both of which were a bit uncomfortable and, as usual,embarrassing, but nothing else. This last one was called a Trans Perineal Prostate Biopsy (TPPB) and was done under general anesthetic. All I had to do was hop up onto the theatre table and lay on my back. The surgeon and staff in the theatre did the rest. No pain at all. When I woke up, I asked how it was going! It was that painless. The TPPB involved the usual anal probe plus small needle punctures on the perineum (the area behind the scrotum). This was done to ensure that the prostate gland was tested all round and not just from one side. Aparently the front piece cannot be reached via the anus. My information sheet told me that I should expect to experience a small amount of blood in the urine, bowel motion and semen for up to 2 – 3 weeks. With the help of the antibiotics, blood from the bowel and urine cleared up after 3 days. I haven’t tested the semen yet as I’m waiting to see out the third week. Having found your website and read much of the experiences of others, I’m glad I waited as I too would have been very concerned. it seems that I have been most fortunate in finding your website which is most informative. Once I have had my appointment with the surgeon I will know whether there is any sign of cancer. On a positive note, my wife and I have been extremely relaxed over the whole affair and, whilst this might not be easy for some, it’s a great help to realise that having a high PSA reading and/or a biopsy does not mean there is cancer. If we treat the “exploratory tests” as just that – “tests” and and don’t go down the “wot if” track, at least the worry won’t take over our mind. Best wishes and thanks to all contributors to the website for sharing their experiences and thoughts. I’ll give an update in a week or two when I get my results.
    urine cleared up

  45. My PSA score was 6.4 when they put me on a months worth of antibiotics. Second PSA score was 6.9 so they sent me to a urologist to schedule a biopsy. She was very compassionate, gave me an antibiotic to start the day before the surgery and a valium to take as I got to the office. Haden’t taken valium before and have to say it was about the same effect as drinking a couple glasses of wine. The injected me with numbing gel in my rectum to help with the pain of the probe, injected the prostrate gland with pain killer but don’t think they waited quite long enough before taking the samples. The stabs of the needles were not completely unbearable but I found that my tolerance for pain is much less than I anticipated. They told me to take it easy for the next week, no lifting, no going to the gym, just kick back and heal. Feels like someone kicked my ass and left their foot up there. Have had no problem urinating and so far no blood. My father had high PSA levels with no cancer, crossing my fingers mine is the same. Always ask for more relaxer than they prescribe so long as you have someone to drive you home. Best of luck to everyone, keep me in your prayers please for neg. results.

  46. My PSA score was 6.0 placed on antibiotics but did not go down consequently I had a biopsy on Monday 24th October. It was a very painful exercise. Maybe it was because my doctor did not give me any anastetic. I was in pain for two days but no blood in urine or rectum. Haven’t tried sex yet been advised to wait two weeks. I am now awaiting results

  47. Ed: You and I are in the same boat….Gleason 6’s. I’m 72 and have had 32 cores biopsied in 3 months. Two cores indicated cancer. Since then, I’ve had urological radiological consults and have undergone a CT scan and MRI with the last two weeks. The CT showed no lymph node involvement and the MRI pin pointed the tumor in the right hemisphere of the gland, contained with the capsule and characterized as “very small.”

    I’ve spent hours researching and subscribed to Johns Hopkins publications regarding the latest developments of therapies and the likely consequences of the same. Coincidently, we are informed by recent recommendations that psa’s and therapies my be contra indicated because the consequences may be more harmful than living with a slow growing cancer that may never be life threatening because of the age of the patient…who may die first from other causes.

    Take your time in deciding. Get second or third opinions. Examine the therapy options and ask hard questions regarding the results of therapies. And by all means examine the option of watchful waiting.

    Along the way, I feel that the options of CyberKnife, Proton or enhanced Brachytherapy best suit me, aside from active surveillance. More and more therapies are coming about that are in the investigative mode that may produce even better results. I haven’t made my mind up yet, but do not feel rushed to make a decision until I’m content with my due diligence.

    I wish you the best.

  48. Hi (Ed W) Sorry to hear about your diagnosis. We are all pulling for you. I went in today for my 4 week Post-op check-up. My PSA was 0.08 which is very good news. The Doc said to come back in three months for another blood test. I’m feeling better every day but I’m still to sore to return to work. Good luck to everyone.

  49. Ed W.
    I’m sorry about the bad news.
    I can only imagine the sleepless nights,and the long days ahead thinking about what the future holds.
    Good luck Ed.Be strong.

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