My Personal Experience on What to Expect During a Trans-Rectal Ultrasound Prostate Biopsy Under Local Anesthetic
Almost 10 years ago, I headed to the National Institutes of Health, National Cancer Institute for a 3T MRI/Ultrasound fusion Prostate Biopsy. You can read about it here: https://www.prostatebiopsyblog.com/first-day-at-the-nih/
This week, I made a second visit due to increasing PSA levels. I again flew into Reagan airport in Washington DC. I used the DC Metro for everything, no need for cabs, buses or ride shares. Last time, I stayed at the Hyatt Regency Bethesda, which is literally right on the Metro, 1 stop from NIH. This time, I found a much better rate at the nearby Hilton Garden Inn Bethesda, about a 2 block walk from the Metro, also easy and very reasonable.
After arriving at NIH, I started with blood and urine tests, an EKG and an IV for administering contrast during the MRI. No chest X-ray was done this time. The MRI sure seemed longer than I recall from last time, but was apparently done in about half the time at just over 30 minutes of motionless time on my back. Thankfully, they apparently no longer use the endorectal coil, which was as unpleasant as it sounds. MRI results were not in by my appointment later in the afternoon, but given my history, the resident physician at the consultation confirmed that a biopsy was indicated. I had pretty much assumed that. Last time it was unpleasant, but this time was going to be local anesthesia rather than general, so I was still anxious. My PSA level was 4.7 in their test, a bit lower than before but still within daily variations.
So, the next morning, I started at 5AM with the enema, unpleasant in itself. After my bowels calmed down, I arrived at the NIH at 7AM for my 7:30 am appointment. And waited, and waited, and waited. Others arrived later but had their procedures earlier, including one gentleman who was clearly angry when he hadn’t been admitted 15 minutes after he sat down for his 9:30 appointment and began demanding to be seen with every nurse that came into the room. I was about to tell him I had been there almost 3 hours already, when a nurse came to have me fill out some paperwork. I also then asked if my MRI results were available and she went to get them. As she returned, she also gave the other gentleman his forms to complete, and then he was off to OR before me… Squeaky wheel, as they say.
Here is a very good guide on the procedure from a physician’s perspective:
The 5 hours waiting for the procedure was also pretty difficult for me, but eventually, my name was called just after noon. Basically, under general, you’re wheeled in, put to sleep and wake up in post-op. Under local anesthesia, it’s a bit different. Okay, a lot different. Here it is from a patient’s perspective. If you don’t want the details, don’t read on. STOP HERE.