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.

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

  1. I had a biopsy a few weeks ago.  Had I known then what I know now I would have refused to have it done.  What ever it was (probe) that was put inside me made me feel like I was being torn apart.  The injection of local anaesthetic was painful but tolerable but the actual taking of the samples had me needing to be peeled off the ceiling because of the pain. (And no I am not a feeble minded person _ I once drove myself to a hospital with a shattered ankle bone so I know I can tolerate some levels of pain but this was quite ferocious)

    After the procedure I left the hospital straight away, I just wanted to get out of there.  For four days I had a miserable time with a great deal of pain ‘inside’ me and a lot of pain where the probe had entered.  The was blood (a lot) and even lumps of something in my urine and passing water was very painful and still is.

    The pain from the procedure has calmed down but I am not completely free of discomfort.

    Thank goodness I refused point blank to both my GP and the doctor doing the biopsy to their demands to physically ‘examine’ me. The probe was dreadful enough and I will never have another test of any sort that requires anything inside me.

    Going to the bathroom is till uncomfortable after well over a week.  I know there are other techniques that can be used for the biopsy and I would recommend anyone needing a biopsy to ask their doctor about this and, having had the biopsy and being told upon refusing the physical exam that the biopsy is the main diagnostic tool anyway I would challenge any man to ask their doctor why they think they have to do this and how they think it will help a diagnosis if they are going to tear you apart with a biopsy anyway.

    Modern medicine has much more sophisticated techniques that some medieval finger inside you that isn’t going to tell them too much anyway. I am glad at least I refused that but I wish I had refused the biopsy too.

    1. Anon- the problem is that even though using a biopsy to sample tissue to detect cancer is diagnostic method right out of the 1950s, there isn’t anything that is significantly better yet. High res MRIs and blood/urine tests are advancing rapidly and getting close, but perhaps not quite there yet. That said, there are a lot of unnecessary biopsy procedures done. They are quick and easy money makers and do have some inherent risks, even though they are done on an outpatient basis. As far as how to know if a biopsy is necessary, your best weapon is knowledge and a second opinion.

      As for the DRE, it costs nothing more than a few seconds of discomfort and if you do have an enlarged prostate or nodule, the doc will know immediately and can track this for you. I don’t see a big downside there, personally.

      1. I have a real life horror story.
        I was treated by a renowned dr. and a top 10 hospital in New York.
        First, do not let the doctors convince you that the potential for infection is 1 in 100. As horrible as these odds are, it is more like 4 in 100.
        If any other medical procedure had these odds, it would not be allowed, but somehow this persists.

        I had a biopsy, and for the sake of brevity, here are the stats from that:
        Given antibiotics before and after the procedure.
        103.5 fever the next day, went to the emergency room.
        Admitted for 5 days with IV antibiotics.
        Home, 3 days later, 104 fever.
        ER, admitted for 12 days of antibiotics.
        6 days later, fever of 103, admitted again for another 5 days.

        Sent home with a 40 day course of self treatment with IV antibiotics.
        Given no further instructions.
        When this was done, I was bleeding from my penis constantly for 2 days. I mean like a chocolate fountain at a Bar Mitzvah.
        Decided to stop taking my Xarelto for a few days, this finally stopped the bleeding 2 days later.

        While I was in the hospital, I had a total of 4 catheters put in over my 22 day stay. I was in extreme pain for much of the time I was there.

        I implore you, do not get this done if there are any alternatives. ANY ALTERNATIVES AT ALL!

  2. The whole process is very goofy and ambiguous. Your PSA is a little high, but without knowing your age or other symptoms (trouble voiding, abnormal DRE) the age your grandfather passed (and if he passed from prostate cancer), I’m thinking you’re not going to get any bad news either. Your results will probably leave you just as confused as you are now. Good luck!

  3. You should be quite relieved about the results you got! Still awaiting my biopsy results.

    I am reading two books: Patrick Walsh’s and Peter Scardino’s books dedicated to prostate cancer. If I need an operaytion, I hope to go to Scardino.

    One suggested waiting a week before ejaculating after the biopsy, and that seemed logical to me given the trauma the poor little gland suffered, and so that’s where I am on that.

    What to do with the results of the biopsy is what I am now reading about, in anticipation of getting the results.

    They have all these probability tables: Partin tables and Han tables that combine the PSA, Gleason and TNM staging, and then present your probability of having something bad. From that a decision is made about what to do, possibly inlcuding more biopsies, waiting or operating.

    Still a lot to read about all that.


  4. Well, my results were good but not conclusive. Eleven cores normal, one core showing precancerous changes (ASAP) They’ll re-biopsy in eight weeks. I’m presuming they’ll focus on the area around that core next.

    Did a test run on the ejaculate (like I need an excuse to masturbate) and it was a pure, vibrant red. Once I recovered from the horror, it looks to me like it’s the combination of the blood and the clear seminal fluid that makes it look a lot “wetter” and fresher than it really is. After that episode, sex hasn’t been on the front burner but my wife wants to get some condoms and go for it here soon.

    1. MJK- a repeat biopsy in 8 weeks after a negative result, even though it had one abnormal core? That sounds pretty aggressive offhand, unless of course you have some other indicator like rapidly rising PSA or a node detected on a DRE. I might get a second opinion before having a 2nd biopsy and bring along the results of the first one. At the very least, consider a different type of biopsy, such as a “saturation” biopsy that takes more cores or perhaps a transperineal one that goes in from a different angle. I think I recall at least one study I read a couple years ago that indicated that a combined biopsy of both types may be superior to a single type. Good question to ask if you get a second opinion! I’d just hate to then have them tell you to keep getting a biopsy every 8 weeks!

  5. Well, I think that the possible complications from the biopsy are now behind me.

    I was surprised by the amount of blood when I first pissed, but was prepared for a clot, thanks to this thread. The clot was large enough to stop my first flow of urine (mostly blood) after about 2 seconds, but with only slight pain, it made its way down the urethra, and shot out, allowing the flow to resume, turning pink pretty quickly from red.
    Each subsequent pee started with red or pink and then cleared up. Today, no more signs of blood in the urine. Drinking plenty of water did help me flush it all out.
    The discomfort was nomimal yesterday (procedure day), and almost non-existant today.

    Feel fortunate that it all went well, And now the wait.


  6. Good to hear, Cliff. I’m still waiting on results but aside from a little blood in the urine the second day and some in the stool the first day, no problems. Definitely sore the day of, after the lidocain wore off but that passed quickly. I finished the antibiotics today. They also gave me an antibiotic by injection before the procedure. Good luck with your results.

  7. MJK, I was in your pact. I let go of the worries, and focused on the need to know, as you suggested.

    I could not get any info on infection rates for a particular doctor, in any case, but it seems that serious problems with infections are very rare.

    I had 12 cores taken today. I had wanted to be put out (twilight), but, as I wrote, that was not a real option, and so I was given 2 oxycodone to relax me so I would not tighten up during the procedure.

    It all went well, as described by otheres before me.

    I am a bit sore, and am going to bed.

  8. Followup to 2/22 post: 15 samples were clear, 1 was “borderline”. Doc recommends another PSA and Biopsy in 6 months. Will not worry so much about the next biospy. Wife has a Masters in Human Nutrition and wants me to adopt the classic “cancer” diet – less than 28 grams of fat per day, cut out red meat & processed foods and increase whole grains, fresh fruit & veggies. Despite years of prostate issues, this episode has been an awakening. Thanks to all that have posted – your words have been informative and it is comforting to know that I’m not the only guy wondering about all this stuff. I wish everyone the very best!

  9. I am 42 years old and an elevated PSA of 3.0 was revealed a year and a half ago as part of my first annual physical exam. I am a fit guy, 140 lbs, vegetarian, run 5 miles 3-4 times each week, do not smoke, drink only occasionally and have always maintained a healthy lifestyle. The next year the PSA level rose to 3.5 and I visited a urologist who advised a biopsy and also a cystoscopy. A second opinion confirmed the same advice. So I got it done – results awaited.

    The urologist offered the option of getting it done under complete sedation, and I took that option. If you have the choice, do it under complete sedation as there is little downside to that except that you need to get to the doctor’s office 20 minutes earlier, and you need another 20 minutes to come out of sleep. I spoke to the anesthesiologist who explained that the drugs they use today for anesthesia are vastly different from those used 15 years ago. The drugs do not stay in the system for too long, and in fact you are not unconscious but in a deep sleep. Deep sleep in the sense that if there was any need for them to wake you up, they could do so. In my case I was up about 15 minutes after the doctor was done, and a bit unsteady on my feet for the next 10-15. I felt no pain after the procedure. My wife drove me back home – oh, forgot to mention this – one drawback with sedation is that you can’t drive for 24 hours. As I type this barely 90 minutes after the procedure, I feel confident enough to drive and feel fully alert. I suspect that is a standard warning/precaution just to keep everyone safe. Can’t fault them for that.

    Anyway – back to the biopsy. I first urinated barely minutes after I woke up, a big clot came out and it was mostly blood. There was pain in the front part of the penis (on the inside, and the front part meaning the first half part of the penis away from the body.) I also felt an urgent need for a bowel movement, and I did that, and it was almost diarrhea and nearly all looked like blood. I am not sure if that is normal, but I will wait for a while to see if it persists.

    I was advised to drink plenty of fluids and take it easy on caffeine for the next few days. So I have had 2-3 glasses of water and am going to skip the caffeine altogether for the next few days. I was also told not to drink alcohol, and that is okay too – I will stay off for the next week. About sex, I was told to wait 2 days by the nurse (the doctor had moved on to the next case). Given all the stories about semen being mostly blood the first few times, I am going to save the wife the sights and am probably just going to masturbate myself.

    So that is how it went, and I will keep people posted if I have a worthwhile update.

  10. Had my 12 core biopsy today. Took one Valium an hour prior. The probe is somewhat thick but it isn’t inserted very far at all, totally tolerable. Two shots of Lidocain, one on each lobe of the prostate. Needle sticks for the Lidocain were similar to the short sting you feel when your blood is drawn. The actual core penetrations were nothing. They hurt less than the Lidocain. A quick snap and the thing is in and out in a second. There’s definitely a sensation associated with the the core needles but I wouldn’t characterize it as pain, more like a quick shallow pop of pressure. The sensations became a little more pronounced as more cores were taken, but again nothing to worry about.


    It’s totally brief and tolerable, and it may well save your life. Results due in 4 days.

  11. I had my first prostate biopsy yesterday. After being so anxiously waiting for side effects after the procedure I am happy to report that the first urination at home contained just a little blood in it….after that there was has been no blood at all…. I never bled from my rectum either. I feel just fine!

  12. 16 needle biopsy yesterday. Waited a month for the procedure and became increasingly hesitant and honestly, my wife says I was experiencing anxiety. The Feb 19 post from Brian is a good description of my experience. The actual procedure took about 30 minutes and I was “in & out” of the Doc’s office in about 60 minutes. Blood in urine stopped after about 24 hours, will wait a few more days to check semen. Some soreness in rectum for about 24 hours & soreness in lower right of abdomen today. 60 yrs old, been under the care of a urologist for about 25 years following a bad vasectomy, PSA slowly creeping up to 9.5 & some problems with urination etc. Won’t know biopsy results until next week but thanks for the tip about John C McHugh’s book -it is excellent & his website is also worth a visit. Best wishes to all!

  13. Regarding bloody ejaculate: I am 20 days post biopsy, semen is finally nearly clear after 5th time ejaculation. I read one source that said it should begin to clear 4 to 6 ejaculations after biopsy. Could be a matter of clearing it out rather than waiting for it to absorb. Seems like most are instructed to wait a week, my dr’s pamphlet said wait only 48 hours (I waited 5 days). It does ruin the love life. If I knew before hand it would look as bad as it did, I would have used condoms. I recommed having sex at about 1 week post-biopsy, then every 3 days or so until it clears. Do it manually if necessary. I didn’t want what appeared to be coagulated blood sitting around in my tubes.

  14. Had my first biopsy on Valentine’s Day, not the most ideal day but the only one that worked with my schedule. Had biopsy scheduled after PSA was 11.0. I had heard and read horror stories about the procedure, I was hoping for he best but expecting the worse. It wasn’t nearly as bad as I thought it would be. The ultrasound probe was the worse part of the procedure. The local anesthetic worked like a charm. I felt no real pain when the 12 samples were being taken. It felt more like a 9-volt battery was shocking my rectum, which was tolerable. I had no blood in my urine or stool until day 2 and then it was very little and only lasted 2 days. I don’t know yet about blood amount in my ejaculate as I am only 5 days out and was told not to ejaculate for 1 week. I am scheduled for Feb. 28 to go over results with my Dr. Thanks to all for your input on this site. I wish I would have found it prior to my biopsy.

  15. Just a follow up on my 1st comments. Its been 4 weeks since my biopsy and I still have very dark blood in my sperm. It does seem less than earlier. does anyone have history on when this will stop.
    My love life is really suffering since my wife refuses to have anything to do with me until it clears up.
    Thanks to all

  16. The blood in the semen is just wrong! I just about passed out when I saw it, and I’m not normally squeamish about the sight of blood, including my own.

    The biopsy wasn’t particularly painful. Uncomfortable, yes, but not awful. Sitting was difficult for the next 24 hours or so, but then the pain subsided. I do feel the prostate now, something I hadn’t really felt before.

    The biopsy was scheduled after a PSA of 5.2, treated with Cipro for a month, then a follow up reading of 4.7.

  17. Like most guys on this site, I did not find it until after I had my first biopsy (13th Feb I’m not superstitious but Valentines Day was a complete was out!!!) but wish that I had – how useful it would have been.

    My experience was fairly typical so I won’t repeat it and much of my worst fears were unfounded.

    I am 66 and my PSA went from 4.5 to 7.1 in around six months. I get my results next Tuesday and obviously hope for the best.

    In the event – I am looking at all the alternative treatments and reading through the blogs I have not found many mention ‘Brachatherapy’ – the ensertion of radio-active seeds into the prostate. My partner was diagosed positive and had radio therapy (5 days a week for 7 weeks) and is now clear.

    Any comments would be most appreciated.

  18. Please see my posts Jan 27th and Feb 2nd. Biopsy result today was T1, Gleason 4+3=7. Have bone scan tomorrow–doc says it’s just a safeguard and not expecting a positive on it. Will proceed with contacting radiologists and or DaVinci drs. to get initial meetings set.

    A little more on my biopsy recovery. The stool blood was a lot day 2 then a little day 3, then no more. Urine stream started pinkish for 5 days after biopsy. Two ejaculations, one at biopsy +5, another biopsy + 10. The first one looked like thick transmission oil, or, for any gals here, looked like the red Close-up toothpaste. Second one was brownish. All in all, my biopsy and recovery was not that bad. Guys, please remember that it has probably saved my life, so it’s worth it. You never know for sure unless you get it done.

    Thanks to all who make this post a great tool for all guys.

  19. Cliff, I think most guys are horrified by the prospect of a biopsy and would want IV sedation, myself included. If you think about it, though, doctors generally want to make things as easy on themselves as possible. So if a large number of patients couldn’t tolerate the procedure without sedation, it would negatively impact the efficiency and profitability of the office. I promise you that, if most patients were writhing in agony and vomiting from the pain, IV sedation would become the norm. Nobody wants to clean up vomit.

    I’m trying not to psych myself out too much about it. I expect rectal pressure and discomfort from the probe, some short stings from the numbing agent, and then a series of twelve more stings, which hopefully hurt less than the numbing agent did.

    I do know that, in those cases where a patient simply cannot tolerate the procedure, they will stop and reschedule you for a biopsy with sedation.

    Since we’re both scheduled within a couple of days of each other, I suggest we make a pact: We will wait until the first core is taken before we decide if the procedure is intolerable. We will not wig out for the next two weeks or dwell on the “what ifs”. The only really important thing is that, if there’s cancer, it’s caught early.

  20. I am grateful to you folks for preparing me for my first biopsy.

    Does anyone know how to find out about the infection rate of an individual doctor’s biopsies?

    My case in brief:
    Grandfather had prostate cancer.
    My PSA was running around 3 for the past few years.
    Jumped up to 6 in January.
    Took antibiotics for a week and then tested for PSA again, and it’s now 8.6.
    Biopsy seems to be required.
    Doctor performs in his office. His prep sheet is as you folks described.
    I asked for the twilight anesthetic a couple of you talked about, but that is only available with an anesthesiologist, wihc means in the hospital, but the hospital doesn’t have the robotic ultrasound biopsy machine whihc he has in his office.
    He presecribed both Cipro as antibiotic and Percoset to relax me and obviate pain because I told him how I hate pain and tense up easily (reason for wanting twilight).
    Scheduled for Feb 29th biopsy. At least the biopsy will only have an anniversary every few years!

  21. I have my first biopsy scheduled 2/27/12. Am 50, no family history for prostate cancer, but lost my Dad to colon cancer at 55 and he would kill me if I didn’t get screened. No symptoms but a pelvic CT for GI issues showed minor changes in the prostate and led me to start doing PSAs every three months. Normal DREs aside from mild enlargement. PSAs ran in the high 3 to low 4 for several months and then jumped from 4.2 to 5.5.

    Uro was recommending biopsy early on but my GP was comfortable just monitoring PSA until the 5.5. That score (and jump from 4.2 over a three week span) got my attention.

    I was dreading the biopsy (although I feel much better and much more fully informed having read the posts here)but I spent the weekend trying to figure out how my wife and three kids would fare without me and quickly realized I needed to stop being a big pussy and just get it done.

    My normal Uro is out on personal leave, so I got a different doctor who I actually preferred. As it turns out, he and his wife just had a baby and is about to be a client of ours at the preschool my wife and I own. I half jokingly suggested he’d want to make the biopsy as comfortable as possible and he half jokingly agreed.

    I don’t expect they’ll find anything but I’m prepared if they do.

  22. I just wanted to say the bloody semen is disturbing.. I had sex 5 days after biopsy, looked like thick, bright red blood. Sex again 3 days later, same except this time darker and brownish. Not feeling good about this going into the wife, nor is she.. So I rubbed one out to get another look by myself, now 11 days after biopsy, it is an even darker rust color, no evidence of any clearing. The Dr’s info suggested a minor amount of blood, but it is a complete color change. I hope the darkening color means it will start to clear.
    I had a 12 point needle biopsy on 1/31 due to first time ever PSA of 3.22, enlarged but smooth per DRE, age 53, and Brother age 54 just diagnosed with stage 4 prostate cancer. A sad and fearful time. My biopsy was clear, am going to have PSA rechecked in 6 months.. The biopsy was minimally painful, have had more pain in the dentist chair. I did not feel the lidocaine injection, but 4 or 5 of the spring-loaded needle strikes had an unpleasant low level stinging pain. For me it was the circumstances of the visit that made it such a sinister experience. If I ever have another biopsy I will request a Percocet + valium beforehand to help with the anxiety. Good luck to all.

  23. I’m a very healthy 65 year old. My PSA in one year went from .9 to 3.0. A repeat the next week showed a drop to 2.7. DRE as per the Doc was normal.
    He advised that I see a urologist. Appt/consultation involved another DRE. The urologist said he felt an abnormality and suggested a biopsy. I had the biopsy on Feb 7th. The doctor had me take Bactrim from the day before the procedure to today Feb 9. I also had to do a Fleet enema 2 hours before the procedure. He also asked me not to take my 81 mg of aspirin for a week before the procedure until one week after. The needle to numb was the worst part. Before the biopsy he looked at the prostate via the tube and said that the abnormality was caused by calcification,scar tissue. (NOT CANCEROUS). However he said I could still have cancer. The whole thing took about 20 minutes. I had a small amount of blood in the stool the 1st time after the biopsy, none since. There has been blood in the urine for the past two days.
    The antibiotic made me nauseous and I lost my appetite. I’m OK now. I hesitate to check my semen. Results available in two weeks.

  24. For what it’s worth, I obtained a second opinion regarding my diagnosis of Pca, Gleason 6, 2 of 31 cores in two biopsies in 3mos. CT negative, MRI noted a small tumor fully encapsulated in the right hemisphere. First opinion: prostatectomy or IMRT or CyberKnife. Second opinion: Active Surveillance.

    I have no intention of submitting to surgery or photon therapies and fully intend to live my life with a better quality than to submit what I believe is rather shameful, facile selection of therapies that are revenue producing, largely unnecessary, and liability based solutions. I happen to be 72, still actively employed, and enjoy pumping iron competition and healthy sex. I understand that my risk of dying from prostate cancer in the future, given my age and with my diagnosis is very, very slim as compared to other potential causes.

    My advice to any who feel intimidated by a PCa diagnosis is to get educated. Read studies, learn the data and in the process understand the relationship between age, diagnosis and Gleason……and get second or even third opinions. The science of prostate irregularities and treatment is constantly changing, even to the extent that some BPH drugs have even been found, in some studies, to have a 30% effective rate in diminishing tumors. Diet, exercise, alcohol avoidance, and even dietary supplements are being found to have cancer fighting effectiveness.

    The determination of therapies is largely based on elevated Gleason summation readings in excess of 6, elevated PSA into double digits and size of prostate. Gleason 6, with single digit PSA and average prostate size and age over 70, with CT and MRI verification of small, encapsulated tumors should absolutely consider active surveillance.

  25. One week later it appears that my urine stream is clearing up. No more bright red blood to start off the flow. My wife and I had sex last night. No problems with orgasm but as the normal rush of pleasure started it was quickly nullified by pain. And I almost immediately regretted my decision. It felt worse than the biopsy had (of course I had Lortab, Diazepam, and Lidocaine in my system then). I used a condom as usual and as I expected, it was full of bloody semen. I immediately headed for the medicine cabinet for Tylenol. I got back in bed waiting for the drug to calm the jackhammer in my anus. Probably after 30 minutes, it subsided and I was asleep. No ill effects the next day.

  26. Thank you David.One of the concerns I had was that if it is inneffective then surgery is at best problematic and at worst not possible.To be fair they have encouraged me to see an oncologist to discuss it next week so it is interesting to get a balanced picture – as you say the stats are not of course going back that far…..decisions decisions…

  27. Please see my case posted Jan 27th, 2012. Saw urologist Tues. She grudgingly agreed to my “confirmation PSA” request and she recommended biopsy. Got PSA result yesterday which she said was “about same” as my PCP got on Jan. 3rd. She did biopsy at 1100 today. Doctor was done by 1115 and back on the road home by 1130. Three levofloxacin 500 mg, each of yesterday, today and tomorrow. Fleet enema at 0830 this morning. No aspirin containing meds allowed 7 days pre and post. Doc first did DRE and found same ridge my PCP had noticed Jan 3rd. But, otherwise, doc said everything looked normal on the ultrasound. She said “if it is cancer, and I’m not convinced it is, we caught it small”. None of it very painful–probe insertion, numbing shots, 12 cores. Only one of them made me wince a bit. Back home, took two 500mg tylenol at 1215 and now at 1415 feeling pretty good. Feels like I sat on a cold stadium concrete bench from halftime to end of game–sore but manageable. Have urinated twice so far w no blood. There was a pink smear when I wiped away the procedure jelly. Path report in about 7 days. Lord, this wait will be agonizing. Will repost then.

  28. Stuart: Before you make the decision to go with surgery, take a look at radiation. If your Gleason was a 6, radiation might be an option for you. I am facing the same thing and am leaning toward brachytherapy (iodine seeds). Also, planning to go for a second opinion for both options (surgery and radiation) next week. I am taking my time and exploring my options. It all started when the urologist (surgeon) really put a sales pitch on me to get it done quickly and wanted to schedule it right then and there. He told me I had “weeks” to schedule it and when I went for second, I was advised that I had plenty of time to make a decision. In fact, my PSA is not even doubling but I do want to take care of it before I lose the options. For me April or May will be the date I set. I have since learned of the differing philosophies between surgery and radiation and how they simply do not share anything with one another. They all have side effects and possible complications and I am very cognizant of that however as it is right now, I simply feel more comfortable with a less invasive approach. Take your time and do the research. It’s frustrating at times to find the data but get second and third opinions.

  29. Thanks to all, Just had my biopsy done a couple of hours
    ago. I am a 67 year old male with a psa of 9 several months ago and a more recent psa of 16. Got talked into test after
    doctor found part of the prostate hard.
    The only painful part was when they went through the wall of the abdomin 12 times. Not a pleasant experience. Best way to describe it is very painfull but not extremely painfull.
    It is just me, but I would not do it again. If I had to have another one I would have them put me out.
    Saw a lot of people on this forum with low psa test and have decided to do the test. Not sure if my psa was that low ie;4,5,6 I would not have the biopsy done.

  30. Had the biopsy a week ago Loss of libido and very painful still.Had the results in 48 hours which were positive .Had a PSA OF 5 and am 57.Looks like a prostatectomy.Despite the deep unpleasantness of the procedure its surely best to know,I now have a pretty good chance of recovery.If I hadnt had it the outcome might have been far worse.At laest I have a choice .Those who keep in the dark may not.

  31. Oops forgot to mention the doc said after examination with the ultrasound my “ridge” or nodule appeared to be nothing more than a “stone” which forms evidently from a previous bout of prostatitis…which i did have in my 20’s (I’m 51 now). He said, “we don’t concern ourselves with those. we leave them alone”. I took that to mean doctors do not attempt to biopsy them. Maybe they are like scar tissue…I don’t know…better research that.

  32. While having a prostate exam prior to a testosterone study, the doc discovered a “ridge”. Follow up with a urologist confirmed some irregularity. PSA levels normal. Ultrasound/biopsy performed. Pre-procedure: Fleets enema 2 hours before office arrival. Did it without help..first time..piece of cake..BM in 2 minutes. Start antibiotic 2 hours before (Levaquin one pill for three days). BTW Doc prescribes 1 Lortab for pain, 1 Diazepam for anxiety, the Levaquin, 30ml tube of Lidocaine jelly, and 30ml of Lidocaine injectible, all of which I am to pick up at my WalMart pharmacy. My Aetna insurance covers neither Lidocaine script. All totaled $90. A call to insurer reveals that they would have paid if the doctor had billed them instead. Doctor says NO..the insurer never pays up when billed. My advice if money is concerned: schedule procedure enough in advance to research different prices and what will be covered. Anyway 20-30 min. after taking the Diazepam and Lortab, I was feeling pretty loose and worry free. Then it was just me and the doc in the procedure room. His instruments and specimen receptacles were all ready. He had me slip my pants down to my shoes, lie on my left side with legs tucked, numbed me with the jelly, and stuck the ultrasound probe up my rectum. He said the body naturally wants to expel it but after keeping it in place for awhile the muscles would relax and accomodate it. Can’t be much more specific about the rest because I didn’t want to watch, but each tissue sample taken was like a prick or pinch. He took 12 from mine. I was so glad when the last one was done. I was coherent enough to talk and ask questions, but still a little loopy. Afterward I just felt internal pressure in my rectum and uncomfortable like maybe you had a hard poop. Oh and after each prick of the biopsy needle this sensation seemed to shoot up my penis like I needed to urinate. I mentioned this to him and he said my bladder was full. Odd since they took a urine sample 3O min. before. So I voided immediately after I left…no blood. I had gas a few times that kinda hurt. It is the second day now and voided several times without blood until this evening when it came out thick and red for a few seconds and then cleared up. I still have not had a bowel movement but I think it is on the near horizon. Kinda apprehensive about that.

  33. Wanted to update here and ask for opinions from anyone who has had radiology in lieu of surgery. My story is somewhere above so I am not going to rehash. I just met with Radiation Oncologist today. For me, I have any number of options available ( pc caught very early) and I am leaning toward the seeds option and against the surgery. Too many people I know have had too many post op complications (ie impotence and incontinence) and at age 46, I am interested as much in the quality of life as i am in length of life. My prognosis with any of the options presented to me is in the 90th percentile for being cancer free in 10 years. There is virtually no difference in odds between using the iodine seeds (outpatient procedure) and any form of surgery (or IMRT for that matter). Therefore I am leaning toward picking the procedure that is less invasive vs surgery and does not require the time commitment (IMRT 8 weeks 5 days a week). Has anyone on the site had the iodine seeds? Would love to hear your experience.

  34. Great blog site.
    I am a 72 year old man and am in good health. My recent PSA test came back at 7.25. So my urologist told me “Ha! biopsy time”. Lord I was scared to death.
    The procedure took about 45 min. First an application of Lanocain up my back side, no shots, and wait for 15 min. Next was insertion of the Ultrasonic mapping probe. Not too bad.
    Then 6 samples taken from each lobe of my prostrate.A little pressure then zing. Several where painful enough to make me jerk away from that nasty little needle. Got thru it with a lot of sweating and the nurse was concerned that I might hurl. But ok there.
    Back home I urinated some blood and clots no discomfort.
    My biggest problem, like a lot of the Guys here, was lots of blood in my seman. I decided to see if mastrubation would help clean me out. 1st time bright red, 2nd time dark brown.
    So I guess I am better. No idea how long it will take to clear up
    Thank God my test came back with all 12 samples showing no sign of cancer. I am golden.
    Get retested in six months for PSA levels again.
    Hope this helps some of you guys

  35. Tim,

    I’m 63 and I had symptoms similar to your’s six month age. PSA jumped from 2.8 to 4.3 in one year. Biopsy was positive in 2 out of 12 samples, one sample Gleason 6 and the other Gleason 7 (3+4)with a stage of T1c. I opted for Radical Perineal Prostatectomy. I had my operation on Oct 5th, 2011. At my 3 month check-up I am cancer free PSA 0.07. You can scan my post to see my progress. Good Luck.

  36. I am 54 excellent health. In 2009 psa went from 1.8 to 2.7 biopsy was negative. This year psa went from 2.9 to 4.2 biopsy was positive in 2 out of 12, one @50% and one @ 5%. Gleason of 7 (3+4) and stage of T1c. Cat and bone scan showed cancer only inside prostate(localized). Had second opinion this week. Now waiting for open surgery…get rid of it and go on with life. Family and friends very supportive. Hope my situation helps. Both of the biopsys were fairly painless, I did ask for more numbing half way through and it really helped. Usual side effects for about 3 weeks….

  37. Gentlemen, your take on my case and thanks in advance, Age 62, good health, only family hist. is one uncle died of it at age 75. PSAs last 5 yrs stable around 2.5; DREs normal. But this year’s physical recently had slight ridge on DRE and PSA 3.6. Should mention DRE was esp. vigorous–this doc told me his dad died from PCa so he goes overboard on patient’s DREs. Read that this can cause avg. .9 PSA increase if blood is taken right after DRE–as mine was. He said let’s wait 6 mths and recheck. I sought 2nd opinion. Internist said my call but MRIs can now be done before biopsy. I bit bullet $ wise and got one. Path. report says: Larger prostate, small node, 11mm, (like a marble in an apricot). All normal on: marrow/lymph/vesicles/rectoprostatic angles. However, “lesion does alter prostate contour and extracapsular disease possible so attention at biopsy is recommended to exclude neoplasm”. Have first apt. w. a urologist next Tues. Should I request the “free PSA”? What am I in for and where will all this lead? I’m really worried.

  38. Well firstly I must thank all the guys who have added to this site and glad to read that elements of my post biopsy are normal it is one week since mine and still awaiting the results. My doctor certainly down played the blood issues that would be coming out of every opening in my body.One the day of the biopsy I went to day surgery as i had a general anesthitic so I was asleep and unaware of what was happening. Howver when at the hospital I had to go to the toilet and when there copious amont of blood exploded from my bowels filling the toilet – the amount of blood I loss saw me loose conscienceness and end up on the floor and longer in hospital.
    In reading about PSA levels mine was 15.8 on first test and then 17 6 weeks later and so now I am a little worried about the outcome of the biopsy.
    I think that one of the greatest things that annoy me is the cost of the procedure. All in all is willl cost about $5000 dollare just for a simple biopsy once you include the over charging of the urologist, the hospital fees, the pathology lab (which I was not told about) the anethetist and so on and so on. God help my bank account if I have to have another one or worse.
    So to me the worse three things are the cost, the copious amounts of blood especially when ejaculating – it is like never ending and the uncertainlty of where to go from here.
    I am a 48 year old white male who is fit, go to the gym 5 times a week and the pefect weight for my height – and no history of prostate cancer in my family – so please explain that one . now all I can do is wait. Once again this blog is great – thanks guys.

  39. Jan 23 at 10am i had the biopsy. I’m 58. I was given 4 antibiotic pills, one a day, starting the day before the exam. My psa went from 1-3.75 in one year. All the information I read was conflicting. the procedure was a little less painful than I thought it would be, maybe i was lucky. i watched the “Honeymooners” on my ipod during the procedure. i highly recommend this. I was also rather euphoric from the local anesthesia, that part I liked. there was no visible blood in my urine or stool, but some slight discomfort sitting down. two days after, i ejaculated pinkish red heavy flow, which i was warned about by the doctor. 5 days later, heavy flow dark, lumpy, cloty blood ejaculation, no pain though either time. i hope the bleeding goes away in a few weeks (?). mostly, I am nervous about the results, and was the procedure even that necessary. there are so many conflicting articles about prostate cancer, and it’s treatment. It was disconcerting to read in a few earlier postings about the possibility of cancerous blood from the biopsy traveling to other parts of the body. I wish to thank everyone for posting their story. With all the confusion, we are still lucky to live in this age of medicine. to be continued…

  40. Thanks David for sharing your experience. I greatly appreciate it. I wish you the very best as you make your decision and as you go through the eventual treatment!

  41. I’m 54 and my PSA ran up from about 3 two years ago to 5.8 recently. My family dr caught it in annual blood tests. Urologist had me take ‘super’ antibiotic to see if it was an infection. It wasn’t. Had biopsy 8 days ago. 12 snips. Blood ran out of my penis during procedure, tons of blood in urine immediately after. A little blood from rectum for about 30 hours. Hard to urinate for a couple of days. Still getting occasional blood at start of urination. Still painful most of the time but low-grade, Tylenol takes care of it.

    Unlike others I got my results in a week. Dr called yesterday, no cancer. Just a slightly enlarged prostate, going back for another digital exam in 6 months. I can hardly wait…

    The biopsy could definitely feel like a humiliating experience if you let it. You HAVE to remember you are there for your health and for those who care about you.

  42. TA: I am a little younger than you and my PSa was 2.9. Had the biopsy and as you can see above they found cancer.

    For ALL:
    I am now looking at options. I have a very good friend who is a Radiation Oncologist (in another town) and his attitude is there is no way he would let anyone cut on him and he recommended IMRT/CyberKnife or HDR. Has anyone had an experience with either technique? Most all on here that had cancer went for the da vinci robotic surgery. IMRT or HDR seem to cut down on the length and side affects. Long term history is not known but 3 and 5 year studies seem to be comparable to surgery. If anyone here has had either therapy, I would like to hear from the patient’s viewpoint how it was.

  43. This is for David. I am 49 years old and I had my biopsy in Sept 2011. Like you, I thought the results would come back negative. They didn’t and I had to weigh all the treatment options. One thing I did was bank my sperm at a cryopreservation center in December. I have always been single and have no children. I always thought I had time to find a wife and have children, well, until the cancer diagnosis that is. I’m home now recovering from Robot-Assisted Laparoscopic Prostatectomy (RALP). My pathology report just came back for negative margins and my carcinoma was encapsulated within my prostate. The surgeon did not take my lymph nodes. As the surgeon told me over the phone, “congratulations, you’re cured”.

    The biopsy gave me a solid Gleason score of 6 and Stage T1c but the pathology report changed that to 6/borderline 7 and stage T2c. The robotic surgery is NO picnic but I weighed all the options and at 49 years old, it was the best choice for me given my life expectancy. I choose a surgeon who has done thousands in New England. If you have specific questions, I will do my best to answer them.

  44. I am black male (may be more prone to prostate cancer). I am 52. My PSA results are as follows 2.3 in 12/2009; 3.0 in 7/2011 and 3.0 again in 1/2012, just 5 days ago. My urologist stated that 3.0 PSA is borderline elevated for my age and that The National Cancer Institute prostate cancer risk calculator predicts a 30 % chance of biopsy detectable prostate cancer, and a 4% chance of aggressive biopsy detectable prostate cancer at that PSA level.

    I read through most of the postings here and I don’t recollect anyone having a biopsy at a 3.0 PSA, especially since there is no increase over 6 months. I am not worried about the potential pain and blood in urine and semen, but I don’t want to subject my prostate to being violated unless it is necessary. I will prefer the DRE exam now and another PSA in 3-6 months. Any and all suggestions are welcome. Best wishes to those going through a difficult time!

    1. Hi TA- Please read this blog from the bottom. It is about choices for PSA levels that are not too elevated, but still above typical for age. Mine was 2.5 to 3.0 when I started.

  45. Had a psa of 5.5 and enlarged prostate. Doctor ordered another blood test, this time testing the free ratio psa. Test came back 12.5% but should be over 25% (low number not good with this test). Urologist wanted me to have a biopsy, so I had to wait 2 months for my appointment. That was yesterday.
    All in all not a terrible procedure. Certainly uncomfortable with a probe up your ass, the doctor used local and then the needles. Think it was more emotional pain than physical plus had two other resident doctors observing and the doctors assistant in there. Full house , and me ass bare…
    They gave me a handout with what to expect, as well as explaining the blood thing. Some blood in urine immediately after and some today but not much. No blood in stool. Will wait a while for a semen check (just can’t think about that right now).
    Have to wait three weeks till I see the urologist and get the results.
    I have three great kids (20, 24 and 26) and want to be around a long time. No question, it was not a fun procedure but would gladly do it again to make sure I can see them all married with kids. ( I’m 56 years old) I guess it’s true, men are wimps…

  46. just got the results back: 5 of 12 samples are positive for cancer. Gleason score is a 6 and I was told I have the slowest growing type (sarcastic “yay”). next up is a CAT scan to see if it has spread to lymph nodes and then to discuss my options with the doctor and my wife. Probably robotic surgery since i am 46. Doc told me cure rate is in high 90’s %. What I would like to know from others here is what questions should i ask. Right now everything is spinning around me. I am actually more at peace with the decision to have surgery (sooner) than I was with the biopsy itself. Probably b/c I won’t be awake for it! Would like to hear from someone who has had robotic surgery so I can truly prepare myself for what lay ahead.

  47. Had my first biopsy a week ago, was not aware of the bleeding from the rectum(it was a lot and ruined my slacks), but all was well by the end of the day, no more rectum bleeding. A week later the blood in urine stopped and I wanted to see how my semen would look, well very dark blood was very scary, will try it a few more times to try and see if the pipes will clear out the blood and become normal again. Have a follow-up visit to get test results on Monday, Feb. 16.

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