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. I just got back from the Urologists office.
    All 14 biopsy core specimens show no cancer.

    As uncomfortable and invasive as it was, I am glad I had the biopsy.

    After 1 week post biopsy I am still dealing with a few side effects.
    Blood in semen but, none in urine or stool.

    My belly aches all day as if I’ve taken a hit to the scrotum. This started around day three. I may have been a little too physically active too soon.
    I get up 3-4 times a night to pee as opposed to 0-1 a night before biopsy.
    It doesn’t feel as if I empty completely when voiding.
    I have to ‘push’ for a weak stream.
    I attribute these things to swelling of the prostate from the invasive procedure and the doctor agrees.
    He prescribed Rapaflo to help w/symtoms.

    I’ll report back in a couple of weeks.
    Thanks again to everyone that has contributed to this site. It help me and will continue to help many others.
    My best wishes to you all. Keep up the fight !

  2. I’m so glad you all have contributed to this site. It seems to be the only real and truthful information available to us anywhere.

    I am 42 yr old.
    PSA cnt 06/05-2.2, 06/10-3.0, 06/12-3.8, 05/13- 4.37, 10/13-3.95
    Abnormal DRE 06/13 with father diagnosed at 65 yrs old.
    I was put on 500 mg Levaquin for 30 days in August for prostatitis.
    It worked and cleared the infection.
    I had my 1st biopsy 5 days ago.
    An MRI ‘over-lay’ was used for specific targeting.

    Results come in three days from now.
    I’m not letting the worry take control. I’m dealing with things as they come.

    I arrived for the biopsy after taking a fleet enema, an antibiotic the night before and one the morning of.
    I was also given IV antibiotics during procedure.

    The nurses said it was a mistake not to have a general anesthesia but I insisted on not going under.
    I had a severe reaction to anesthesia 20 yrs ago and almost bought the farm, so when I don’t REALLY need it, I go without.
    This proved to be the right decision.

    The initial injection of the numbing agent (Lidocaine) was the most painful part of the entire event.
    It burned throughout my urethra and was a 4 on a scale of 10.
    The core needles were painless but the prodding of the probe against the gland was a dull ache that stayed with me for a few hours.
    The entire procedure was about 17 minutes.
    I took it easy the 1st day and slept a lot but resumed daily activities with care thereafter. I can tell I won’t be working out or doing hard exersize for at least a week.

    “Normal” blood in urine at start for what is now the 5th day, a few clots now and then if I haven’t had enough water. Slight blood in stool 1st day but none afterward. Bright red blood ( a lot) during ejaculation. This was the second day when I decided to test the plumbing. I am going to stay out of that neighborhood for at least another week as it didn’t feel good and gave me a belly ache afterward that lasted a few hours.

    Day 5 and I feel good but am still on antibiotics for a chest cold I had going in. I had mentioned this to the Dr and he said it would not be a problem.
    Unfortunately, my body is now fighting a double hit and I would have waited to be %100 healthy going in if I could do it again.
    Overall, it was not very painful and simply an uncomfortable experience.
    The benefits far outweigh the risks.
    Whether or not I am diagnosed positve for PCa, I know the biopsy was the right decision.
    Thanks again for all the insight. It’s easy to feel alone when honest information is so hard to come by.
    This website is incredibly important for everyone facing these challenges.

  3. Had two biopsies two years ago and slowly lost ability of erection. PSA ranges from 5 to 7 None of the stimulants seem to help.

  4. PSA is an antiquated, unreliable index. The same could be said for prostate biopsies…which are essentially shots in the dark and could miss rapid growth cancers. What we have learned over the past three years, especially, is that males with diagnosed prostate cancers in age group over 70 frequently have slow growing cancers that may never require treatment at all.

    Even in younger age groups, males with slow growing cancers may benefit more from Active Surveillance than prostatectomies, photon, proton or brachytherapy.

    I, personally have a PSA of 18, and have had multiple biopsies and multiple MRI confirmations of confined, small, slow growing prostate cancer. Imaging (MRI) is increasingly graphic and accurate in pinpointing prostate cancer without the search and staple aggravation of biopsy protocols. Especially with the advent of T3 MRI’s. I have a healthy, active life on Active Surveillance.

    I recognize this is a biopsy oriented site, but that , in itself, is constricted because it confines the dialogue to biopsy experience and not the whole of what it is supposed to accomplish in diagnosis and treatment. I encourage self education though competent sites, all in the interest of permitting the patient to at least have a rudimentary understanding that not all prostate cancers are the same and some should simply be left alone and monitored.

  5. Update … I went to the urologist today to get the results of the biopsy. I was scared to death in what he might tell me.

    Well, everything was normal. No cancer. Now all I need to do is go back to him and have another PSA test in 4 months.

    He even gave me a script for underarm applied testosterone (Axiron).

    Thank you Lord

  6. I am 65 years old and am pretty healthy overall with no medical issues. During my last annual physical which was about a month ago, I told my doctor that I had been having erection problems for the last 6 months or so. I asked if I could get a presciption for Viagra. When I say “erection problems”, what I mean is that I get an erection, but it is not as hard as it used to be. My wife is alot younger than myself, and she has even complained a little about it lately.

    My doctor recommended that I have my testosterone level checked, as this may be the reason for for my erection problems. Well, my testosterone level was found to be 280 which for my age is very low. However, at the same time they tested my testosterone, they also tested my PSA and found it to be 4.5 which is too high. This is the first time I had ever had my PSA checked.

    The doctor told me he could not at this time give me supplement testosterone with an elevated PSA because if I did have prostrate cancer (high PSA), the extra testosterone would cause the cancer to possibly grow much faster.

    He then had me see a urologist due to the high PSA. Well, 5 days ago this urologist did the prostate biopsy in his office. This was the usual procedure of removing 12 core samples. I had no ill side effects from the biopsy, but this morning my ejaculate was like others here; very red. In fact, it looked to me to be almost pure blood … very scary to say the least!

    This Monday I go back to the urologist to get the news on the results of my biopsy. I am very nervous about all this, and unfortunatly my wife is out of the country on business, so I have nobody here to help me emotionally. I am just all alone right now, and my wife won’t be back home for another 2 weeks.

    If the urologist does tell me I have prostate cancer on Monday, its going to be very difficult telling my wife over the phone about it. I probably made a mistake even telling her about this. I should have waited until she came back home, but it’s too late now … she is already waiting for the news from my urologist visit on Monday.

    There is no prostate cancer in my families history, but as Monday gets closer and closer, I am really getting very nervous about all this … very nervous.

  7. I had my procedure around the end of June. PSA was 5.1, digital exam was normal. I had absolutely no symtoms just an incompetent general practitioner that had not performed a PSA test although she was doing regular blood work every 6 months. I am 58yrs old. I changed doctors due to another problem with the previous one and the new doc ran a complete work up and found the high PSA level. I highly recommend the biopsy if ordered. It saved my life. Results were 4 out of 12 samples malignant on the left side only. I had robotic surgery on Sept. 13th. As far as the blood in ejaculate, dark red and scary the first time then brown then the last time before surgery looked like a chocolate vanilla mixture. My next hurdle is experiencing a dry orgasm without ejaculate. At least I am now cancer free.

  8. Had my procedure on the 19th of sept. I was really anxiuous and scared of the unknown. With this said, the biopsy was done in over 30 min. with the worst being some pain after medication wears off. little blood in urine for one day and also in my stool for one day,My main concern is the black dark ejaculate its been close to 3 weeks and my seamen is dark,I guess it will clear up eventually. My Dr. request another biopsy, something atypical cells, but I am possibly not going thru this again, my PSA # is and has been a #1 and until there is a difference I’m not going thru this stress again.

  9. I last posted on this site in 2011, I am now aged 68 and had another biopsy 9 days ago, my third to date, this was initiated by the urologist as he feels it should be done every second year, I understand if this is clear then apart from the routine three monthly PSA tests there might be a greater gap before the next biopsy. Cancer showed up in my first biopsy but nothing in the second one, I will know more on the 17th October, I will say that knowing the routine this last biopsy was more painful than the others, it felt like the man with the needle was mining for gold, this was the first time I have had clots of blood when peeing, as I was sitting typing a dark blood drip came out of my penis, so given my previous experiences, I would think there is a strong possibility that some of the discomfort and after effects are down to the luck of the draw as to the ability of those who carry out the procedure. Off for ten days to Lanzarote, so fingers crossed for the 17th… good luck to you all.

  10. I’m 58 years old and have a family history of prostate cancer. Regular annual PSAs were 1.0 and 2.0 since the 1990’s and a year ago it moved to 5.4. Biopsy and ultrasound three days ago. The doc put me under with Propapol cocktail. Like taking a short nap and it was all done in about 20 minutes. Really groggy feeling till the cocktail finally wore off. Thank God my woman was there with me.
    Needed pain killers were needed that day, along with a nap. It took me 6 hours before I could urinate, I imagine due to the swelling. Only noticed bloody stool twice over the last 72 hours.
    Of course I’m worried about the Libido, it’s only been three days but I haven’t had an erection and that’s a little worrying. I’ve read some guys take a performance hit, but I’m thinking it may be the concentration on the potential discussion of the biopsy results, i.e., it may be mental.
    Back at work now. Test results in 10 days. I wouldn’t want to do this every day, but guys don’t let the fear of the procedure stop you from getting this done. I have had worse dental visits.
    Wish me luck

  11. I”m 64 and have been suffering from BPH for several years now but had it under control with meds until January this year and became concerned. My urine flow was not normal so had my PCP refer to a urologist who did DRE. He sais my prostate was a little large and ordered PSA (3.2) My urologist was a little concerened with PSA and put me on meds to reduce the size of my prostate and PSA. In six months PSA re-test(2.0)Which was doubled to (4) because of meds i was taking. My doctor recommended Biopsy in his office. Had PSA re-test 4 weeks later (2.8) again doubled to 5.6 because of meds(Proscar) i was taking. After researching the procedure i opted for having procedure it done in the hospital. Procedure went fine without any pain.I was up and walking 20 mins after i came out of anesthesia. If you’re going to have biopsy done i would strongly urge that you have it done in the hospital. I had same side effects as others… Blood in urine for about 4 days and in semen for about 10 days. Unfortunately, my biopsy came back with 3 cores showing postive and a gleason score of 6. I an now weighing all my options; wll be meeting with oncologist in about three weeks. Good luck to everyone!!

  12. I had my biopsy 10 days ago. It was not bad at all… a little discomfort each time a sample was taken (12 total). I was done in less than 10 minutes.

    I never had blood in my stool. I still have some blood at the start when I urinate. And still have lots of blood in my ejaculate, though it is more brown now.

    All of these are really no big deal and I would regard this a pretty mild procedure since I returned to normal behavior within 24 hours. Thinking about it, I would categorize this about the same as a Colonoscopy.

    Got my test results back today and 10 of the 12 samples came back negative. The other two are undergoing additional testing (triple immunohistochemical staining).

  13. Had prostate biopsy last Saturday. Little to no pain, and doctor took 12 samples. It felt like someone was hitting me with a bb from a sling shot. He also talked me into taking a testosterone shot in the penis, which makes me wonder if this may be good news that he wouldn’t prescribe testosterone if he thought I had cancer. It’s Tuesday today, no blood from rectum, but a significant amount in urine stream, especially when just starting. Waiting for biopsy results. Doc also said I have a Hydrocele caused by a hernia that needs to be done soon.

  14. At 55 had biopsy under sedation 80 hrs ago. Antibiotic the day before, of, and after procedure. Great Doc and practice. Went to them after visiting the first urologist to whom my GP referred me. That guy saw me for all of 5 minutes, did DRE (normal) and prescribed biopsy. Was going to do the in-office type under local anesthetic. I said NFW and went to see the guy who eventually did it. He explained that biggest risk is infection, so he types the bacteria in your system (swab from the DRE) to the best antibiotic for that bacterium. Sounds smart.
    Procedure protocol was identical to colonoscopy. Hospital robe, gurney, IV, the works. They gave me addt’l antibiotic thru IV, right before the good stuff that whacked me out for 30 mins or so. Felt absolutely nothing. Got up inside 20 mins after waking up. Managed to pee right away, no blood. Blood started about 24 hours later – varies in amount and color, but always the lesser part of urine. No pain, no burning, etc. and no fever (that’s the condition to be on the lookout for). Yes, disconcerting, but Doc said to expect it. V little blood in stool, and not every time. Haven’t ejaculated yet – one of the after-care sheets said to hold off for 72 hrs. Now wondering whether I should be “flushing” like some folks argue here. Win-win?
    Doc said results in 7-10 days. W PSA that went from 2 to 8 in 7 yrs (I’m otherwise fit and healthy w no family hx), he still figures it’s only a 33% chance there’s any cancer. Fingers crossed.
    Even though I don’t yet know outcome, I feel great relief for having done this; so much conflicting info and advice out there, but bottom line is that if you DO have something, and you lose valuable time diagnosing it, the fact that this debate exists isn’t going to get you back that head-start on treatment that could prove crucial. All the more reason not to delay, given that a biopsy under sedation is a piece of cake. Good luck to all.

  15. I am 52 and had my biopsy last week. The procedure wasn’t bad (thank you for the sedative)Had some pain the next day and some blood in urine the 1st day. About two days later I started to have a low grade fever just under 100 but enough to be bothersome. The Dr. called in some antibiotics and they seemed to have helped with the fever. Now I am experiencing difficulty and pain when I urinate. I never had any problems with my prostate till after my procedure. Get results next Wednesday

  16. I am 62 and had a biopsy performed 6 days ago. I located this forum as today was my first blood in urine. Apparently it is common although I figured after a few days went by I was okay. I had a 7.5 PSA with no symptoms and I don’t have a result yet. It is clear that the procedure itself is a different experience for many. For me, it was an office visit with an unsuccessful attempt to ram that giant dildo home. It was absolutely the worst experience I have ever had. “One more time” was the phrase used by the doctor as he kept trying. I tried relaxing and also bearing down, techniques that had been recommended but nothing would work. I could see an extreme grimace on the face of the nurse as if to say “OMG – that poor SOB”. Finally, the doctor, who was now perspiring, apologized and said that I would need to be sedated. Another appointment where I was knocked out was successful although the feeling that I briefly hosted a 32 inch aluminum baseball bat is not entirely gone. Believe me, if you have an option, have them put you to sleep.

  17. I am 57. VERY low PSA. Lower than normal range. DRE suggested I needed biopsy. Turned out to be calcium deposits? I have not suffered any issues in 4 days now. Scared to death every time I have to urinate. I am so relieved (no pun intended) every time I have to go, and actually go.

  18. Roger: Out of curiosity, how old are you and what level of PSA, or other factors resulted in your submitting to the biopsy? Your results are as extreme as I’ve read here.

  19. Had my first..and only biopsy 8 days ago. Results have returned negative. At the point that I found out my negative result, I couldn’t have cared less. My post biopsy experience has been horrifying. 5 days after biopsy, I almost went to the emergency room. I was unable to urinate for about6 hours. Although my bladder was feeling like it was going to burst, I could not urinate. Just about 1/2 teaspoon of blood. Kept trying to relax and go back and try again. Tried going to bed, since I was supposed to work in the morning. Finally woke my wife up just past midnight, to drive me to the emergency room. Tried to relieve one more time, and FINALLY passed urine, and a couple of large blood clots. Again, horrifying. Went back to urologist the next morning. I was passing urine OK now. Dr. said that the worst was past, and to drink plenty of water. 3 hrs later I passed another clot that looked to be the size of a chicken heart. OK after that. Went to work the next day. OK. Got home that night and started experiencing the same issues as 2 nights before. Only a few drops of blood passed while bladder was bursting. I live in the woods so I could go outside on my deck to pee off of it. I could change positions this way, and lean on and bend over the railing. This seemed to help in passing urine. Could not have done this in the bathroom. Passed another clot the size of a chicken heart. Then on my next try, passed a clot the size of a small clam. I have been having some pain, and difficulty urinating, and feel that something is blocking me from emptying my bladder. I am worried that I will have to go to the emergency room to be catheterized. Of course I experience the worst of it while my urologists office is closed. It is the weekend. Based upon MY experience, I think that doctors are a little cavalier about recommending and performing this procedure. I can say that it was not worth it. But maybe I can say that because my results were negative. I am traumatized. I am not a sissy. If I was passing blood in my urine, stool, or sperm, It wouldn’t bother me that much, but these huge clots are again, HORRIFYING. Wondering if I’ll ever be “normal” again.

  20. This is a very helpful site. I, too, just navigated the PSA/biopsy gauntlet with the following profile:

    -Age 51
    -Never any prostate enlargement or other issues
    -First ever PSA test Feb 4 was 4.8. I was put on two weeks of Cipro to rule out infection.
    -Retest March 6 = 3.0
    -Retest April 9 = 3.4
    -Retest May 8 = 3.3

    Had 12-core biopsy June 5. Took 500 mg of Cipro and used fleet enema two hours before procedure. Also received a shot of antibiotics in rump 5 minutes before the biopsy began. Experiences vary widely on this board, but this procedure was far more bizarre and painful for me than advertised. Perhaps I was immune to the “freeze” injections that were supposed to numb the prostate, but I found this procedure surprisingly barbaric and more painful as the procedure continued. Is the same needle used to collect all 12 samples? If so, I wonder if the needle becomes duller as the procedure goes on.

    The procedure lasted about 10 – 15 minutes after which the doctor advised me to continue lying down. Good advice. I cooled out alone for about 5 minutes then got off the table, got dressed, had lunch at the hospital and drove myself home. I kept a bottle of Tylenol in the ready position because I was anticipating post-procedure pain, but there was none. Had blood and clots in urine, particularly days 2 -4 after the procedure. The clots are a little weird but not painful. As others have described, your semen is going to be a shock — completely bright red blood (think mass murder) which begins clearing quite a bit after about a week. I had no blood in my stools or other side effects from the procedure.

    A prostate biopsy is an unusual experience, but it’s the best tool we have to ferret out prostate cancer, which is a heck of a lot more painful and agonizing than this 10-minute procedure. It’s definitely worth the trouble. I received my results today — no evidence of prostate cancer thankfully. But my PSA is still higher than it should be for some reason (and I don’t have BPH or an infection) so I’m going to consult a nutritionist and naturopath to research ways I might alter my diet or lifestyle to get that damn PSA down. Otherwise, I’m on the PSA-biopsy treadmill every year… and another biopsy is something I’d like to avoid if at all possible. Good luck to everyone. If you need the test, just get it over with and move on with your life.

  21. Great site and it’s interesting reading to see what others went through… i had my biopsy today, 15-5-2013, i’m 56 years old living in Adelaide, South Australia and i found it quite painless although a little uncomfortable with the first probe going in… after that i did feel 2 small numbing injections and a few moments later the doctor started plucking the first of 12 samples, i could feel them but no pain to speak of.
    It took about 10 minutes for the procedure and after a bit of advice when to take some more antibiotics, getting dressed etc.., i was on my way home.
    The only blood flow so far is out of the rear passage when i had to have a bowl movement, a fair bit too but nothing in my urine so far and it’s been about 10 hours since the procedure and i’m feeling a little sore now around the bum but a pain killer before bed should help. I do know one thing, it’s not as embarrassing as i thought it would be, the doctor and nurses attending were fantastic.
    Now it’s a wait of about 2 weeks for the results, hopefully it’s just an enlarged Prostate that comes with age, fingers crossed.
    All the best to all posters here.

  22. My view of PSA and biopsies remains the same….that these are unreliable data points to justify aggressive therapies absent a justifiable Gleason score. I have never understood why, in god’s name, do urologists insist on CT scans and MRIs to “pinpoint” tumors for accurate dosages of photon/proton therapies….and don’t use the same BEFORE a PSA driven biopsy.

    I”ve just had my second MRI, a T3 diffusion scan, which identified the mass and characterized it as “low potential for rapid growing” cancer. This coincides with the same findings of my numerous past biopsies. Under the circumstances, there should be no further need for biopsies.

    In today’s news, we now know that there are now available, alternatives to biopsy by means of DNA tests which measure whether a Pca is fast or slow growing. One is Polaris, offered by Myriad Genetics ($3400): the other, Oncotype DX Genomic Prostate Scan ($3820). There may be others.

    I fully recognize the purpose of this blog is to record personal experiences through the prostate biopsy process. However, I continue to believe that this process tempts radical and debilitating results, often by cancer phobic ignorance of non-invasive alternatives (Active Surveillance). Urology, it seems, has a ways to go before it extracts itself from the dark age of facile recourse to needless surgeries and radiation based on PSA and biopsy alone, without first considering-or first ordering-the diagnostics afforded by imaging (T3 MRI) and the new DNA tests. My comments are in no way intended to diminish the need for aggressive therapies where fast growing tumors are identified.

  23. I am 62 and had my biopsy on Tuesday and got a call today that all came back negative. I’m really happy about that.
    After the procedure I had a little discomfort and a small amout of blood in my stool sample. I was told this would happen so it isn’t bothering me much.
    However, I decided it was time to see what happens when I ejaculate. It scared the crap out of me. My semen was blood red.
    I found this website and have read many of you gentlemens remarks. If it wasn’t something that appears to be pretty common, I would be on the way to the hospital right now.
    Thank you all for relating your stories, it has made me feel a lot better.

  24. My biopsy results came back negative, and now I’m on an emergency surgery list for a TURP – the dreaded reaming!

    I don’t like what I read about TURP and am looking to see what alternatives there are – Green Light laser at first glance seems a lot less invasive and traumatic. Has anyone had that?

  25. My quarterly PSA (I’m on active surveillance for a Gleason 6 Pca) came in at 18.2, which caused a momentary hypervent, until I reflected on my history of gyrating PSA’s ranging from 6, 8, 16, 11, 7.8, 13 and the big 18.2. My history of prostate infections and BPH has caused some of these anomalous results and my next PSA, preceded by doses of Cipro, should be either comforting or…. Regardless, I’m heading for a Diffusion MRI in a few days, with the idea that the lesion can be identified and measured…and compared with a contrast MRI that I had a year and a half ago. My hope is that imaging will give doc and me some idea of the growth characteristics of my cancer to measure against my biopsy results of six months ago.

    I continue to be a very positive advocate of Active Surveillance and will remain on it until confirmed, accelerated growth of my Pca dictates therapy.

  26. I’m 65. Healthy, active, vegetarian. Have always been told my prostate was a little enlarged but nothing to worry about. Finally after having lower abdominal pain for some months, slow urine stream, and an increasingly dull background pain in the prostate region, another PSA was ordered that came in at 6.4. I was referred to a urologist who assured me it was just an infection – prostatitis – and not cancer. He prescribed antibiotics for 28 days.

    Luckily for me a locum at the clinic where I go had ordered an ultrasound too, which showed my bladder was not voiding completely, and that my prostate was 83cc instead of the normal 15cc (which makes me doubt the usefulness of the annual finger up the backside if the doctor can’t distinguish the difference between a “little” enlarged and something that is almost 4 times its right size!). All of a sudden the specialist who had said it was not cancer was pressing panic bells and telling me I had to be open to the possibility it is, and I was scheduled for a biopsy.

    The biopsy was done in a hospital, and after the first 3 nips were done I was lying back wondering what the fuss was about. Then the 4th one came – wow! – that hurt!! Then the 5th – that was absolute agony. And then the 6th – how do you describe pain that is 100 times worse than absolute agony?? I don’t know if he struck something diseased or an area he had not anesthetized properly.

    The Doctor stopped there at 6, and like so many posts here I am now waiting on the results. A few drops of blood in the urine, but I’m sure that was more from a tear in the urethra from the probe than any blood in the bladder. Some rectal bleeding for half a day. But like most here, it was the bright red blood in the ejaculate 3 days after the biopsy that was the shocker. I too had been given literature that spoke soothingly of the “possibility” of a little blood clotting, but nothing prepared me for this. I only wish I had found this site first – it has been far more valuable to me than the pamphlets they hand out.

  27. Date Age PSA
    PSA Tests:
    16-May-02 43 1.80
    24-Jun-04 45 2.26
    23-Mar-05 46 2.05
    14-Jul-06 47 2.25
    17-May-07 48 2.15
    13-Jul-07 48 2.69
    29-Oct-08 49 2.56
    10-Apr-10 51 3.20
    18-Oct-10 51 4.07
    11-Dec-12 53 5.27

    Other:

    PCA3 Test 35.00
    25-Oct-10 Ultrasound
    16-Dec-10 Biopsy # 1
    14-Mar-13 Biopsy # 2

    I am one to have an annual physical, and sometime after my 40th birthday, my doctor started to request that I complete PSA tests. All was going along smoothly, until 2010 when I had my first PSA fall outside the normal range. It was 3.20
    The doctor then requested that I take an Ultrasound. Nothing particular showed up on the ultrasound in October 2010. It was suggested that I have a biopsy, and I was scheduled for December 2010. The urologist pointed out that all the current tests for prostate cancer have shortcomings. The PSA is not a great indicator, and the biopsy is limited to whether the 12 samples actually hit any cancerous cells that could be anywhere. The chance of a false negative was about 20%.
    I had the biopsy, and it went very smooth. I went out that night, and there wasn’t much pain during the procedure or after. I did have blood in the urine for a few weeks, and blood in the semen for a week or so longer. 10 days later, I received the good news that all 12 samples were negative for cancer.
    Subsequently, my PSA continued to increase to 4.07 and then 5.27. The urologist suggested that there was this new genetic based test called the PCA3 test. In Canada it is not covered by our healthcare system, so it was at a cost of $400. I took the test and it came in at 35. Based on my PSA of 5.27 and my PCA3 score of 35 and the fact that I had one clean biopsy, it appears that the likelihood that a second biopsy would be positive for cancer was 49.6%. I was starting to not like my odds.
    So in March 2013 I was scheduled for a second biopsy. As the date came closer, I started to read blogs on the internet. I was seeing that people with similar scores to me were getting a positive on their biopsies (either first or second). I was more worried about side effects this time (ie. sepsis blood infection).
    The day came, and the doctor started the procedure by giving me some freezing. The needle hit a nerve and I jumped and tensed right up. He said to me that that only happens once a year. I am not liking how things are starting off here. Since this is a second biopsy, he is taking 18 samples. The procedure is completed, and they tell me to drink some water and go to the bathroom. Low and behold, I cannot urinate. They say sometimes this happens, so I should go home, relax and try to urinate at home. I go home and try but nothing comes out. My bladder is bloated and painful. I return to the hospital, and they say that they will insert a catheter to provide me relief. The doctor says that he can take it out, and all will probably be well, but he suggests that I keep it in for a week. My prostate has either swollen up or I am blocked by blood clots.
    Needless to say, a week with a catheter was horrible. I also was constipated for the first four days (until I took a laxative). The catheter and constipation took my focus away from the pending results. Seems everything that I read on the internet were cases of people that had negative outcomes. I had the catheter removed at the end of the week, and I had another week to wait for the results. I started to get very nervous as to the repercussions of the results. The result came in and all 18 samples were negative. It seems that my prostate is just inflamed. It appears that the likelihood of a false negative after two biopsies is less than 4 % (I guess 20% x 20%). So while this second biopsy was a horrible experience, the outcome was great. Good luck to everyone going through this, and hopefully they develop better tests, procedures and treatments.

  28. This is the follow up to the March 17 post. 4 out of 12 cores taken were positive. Gleason score was 3+3=6 for each. No palpable mass. PSA 5. Classification is borderline low risk to intermediary. Urologist recommended proton beam radiation or radioactive seed implants. I chose the proton beam because my 3 golfing buddies swear by it and have no incontinence. Others who have had surgery or standard radiation have to wear pads or depends. Impotence vary with all treatments, but most have it. I have been approved for the proton, but the wheels of paperwork grind slowly. Biopsy after effects (since 3/12/13)are somewhat annoying: 3/10 prostate pain like a healing laceration but responds to analgesics. Diminishing blood tinge in semen with spotting on underwear. First ejaculation burgandy colored. No sex since. I was feeling so much better prior to the biopsy and with the aloe vera capsules, I was thinking about canceling, but now I am glad I had the test since it revealed the cancer. I am now praying paperwork to get resolved to get going with my consulation with radiation oncologist and subsequent treatment at Loma Linda University.

  29. I am 54, last October, about 5 months ago I had a routine check up. PSA 4.1 dr was concerned and was going retest. The next week I ended up with a nasty virus, in bed for around 9 days, fever to 104….Another PSA test showed 9.2….dr said must be tied into my infection…

    Followed up with urologist…recommended biopsy…did the shots and the 12 samples…results show negative….but what I have read is that you must hit spot that has the cancer for it to be positive?

    Also its been few days and I wanted to give it a trial run….a little pink in the semen is the opposite of what I had. I am married and thank god my wife didnt scream…solid blood…totally…

    No pain, just scarred the hell out of me…..good luck to everyone.

  30. Read many of posts, mainly the most recent. Conclusion: large variations in experiences from “no big deal” to “never again.” Medicine is still an art and there are no cookie-cutter answers for everyone. My situation is a little different: Will turn 67 in June. Have a 36 year history of prostatitis requiring antibiotic therapy which has always brought down the PSA to within normal range, until recently. I urged my Primary Physician to send me to a urologist since I have been quite weary dealing with my symptoms: perineal, bilateral hip, and low back 5/10 pain, treat with NSAIDs. PSA was 6.7 in December but came down to 5 with Cipro. Urology consult revealed normal digital exam and Dx of chronic non-bacterial prostatitis. Rx for Elmiron or freeze-dried aloe vera capsules. Symptoms dramatically reduced 90% but I prefer the aloe vera regimen since these caps can be taken with or without food; whereas, Elmiron must be taken on an empty stomach. I decided to go ahead with the specialist’s recommendation for a biopsy (for additional information and some peace of mind) which was done last Thursday. For me it was not unbearable, but it was unpleasant enough to do some rethinking if it were necessary for repeat as I would opt for MRI with Vivid/Look software first. The computer tech said I had a prostate of 60 gm. and compared to my PSA of 5 that was promising for a negative for ca result. Results of biopsy will come in a week. I was put on Augmentin antibiotic as I had been recently on Cipro and there has been some resistance to this quinolone and I had just been on it and had used it for years. I am a retired AZ oncology rep and my son is a FP physician. I am eager to get the results of the biopsy and eventually in a few months to repeat the PSA test as I believe the reduced inflammation in my prostate (with aloe vera therapy) may have an affect on that reading. I will post again next week with the results.

  31. Hi, Im 55 years old, and my PSA went from 1.to 6.2 in 2 years. Dr ordered a biopsy so it happened 7 weeks ago,, and I thought Id bring you all up to date. Originally they said 6 point but it became 12 points. The day of the proceedure I did the Fleet enema twice, and even did a salt water rinse to be sure I was completely clean prior to proceedure. I used the same Fleet plastic bottles to do the salt water, (Salt water generally kills most bacteria), and dont drink salt water, it will make you vomit. Anyway, the proceedure went as discribed by most others on this blog. I was in the Urologists with a female assistant. They do this proceedure all the time, so they knew what they were doing. I would say it was an uncomfortable and slightly painfull proceedure, and I was glad when it was done, but needed to find if I had cancer or not. I sat and recovered for about 15 minutes before attempting to leave, so I would recommend a rest immediatly afterwards, (dont jump up). And from the ultrasound I had no tumors and when the results came back 4 days later, one of the twelve needle biopsys tested positive for cancer. The Dr gave me a list of options, radiation, watchfull waiting etc. I elected, since Im so early in the cancer process to do the watchfull waiting. Afterwards urine and stool were pretty normal, but my first my ejaculate disturbed me being the color of burgandy wine and has remained so for 5 weeks, and the last week or so, the color of honey, and at 7 weeks still waiting for white.
    I will have another PSA in 6 months and another biopsy in 18 months. I also changed my diet. Cut back on red meat & sugar, and increased my vegatables quite abit, broccoly and spinich. I also take Tumerick and Curcumin, or Curry. -the Curcumin I take is a concentrated Curry extract pill form.
    Nobody on here has said, but men in India have the lowest incidence of prostate cancer, (one tenth that of western men), and they think its due to their daily consumption of curry. I take a pill thats 9 times greater in concentration of Curcumin. (Its NOT Cumin as in Mexican food) -also its sold on Amazon.com, Life Extention makes a great pill for this. Anyway, Im getting alot more exercise (walk up to 20+ miles a week) and my colestrol went down 35 points (I startd my excercise program 4 months ago) and Ive lost 10 lbs, down to 200lbs. Anyway, hope my data helps and I’ll update you all in the future, -although someone is monitoring this site and removing some of the blogs,, thx, M

  32. Hi Guys, great site. There is more information on here than anywhere I have seen. I’m 47, no family hx, PSA went from 2.4 to 3 in 1 ur. DRE by PCP found sand crystal size node, maybe & 2 follow up DRE’s the intern & UR thought they felt node, “maybe”. Ultrasound & 12 core biopsy was 2/5/13, no nodule on ultrasound.

    Procedure was uncomfortable but bearable & went to work afterwards for 4 hrs, office mgr. Blood in urine almost 2 weeks but less each day after 1st wk. I waited 10 days before sex and first couple ejaculations bright red blood & chunks of something. Now, semen is dark brown & looks awful. I’m not sure how much longer this will last.

    Results received last week & negative. I received lab order for 6 mo follow PSA. Also, a couple days ago a voicemail from urologist office saying Dr wants to do a follow up mdx test, I think. The caller wasn’t real clear but left another number to call for someone else in the office. I’ve left 2 messages the past couple days without a return call.

    Anyone have post negative biopsy test other than PSA? And, how soon can I expect the brown sperm to clear up? Good luck to all.

  33. Age 63 here. Good physical shape. Never smoked. Had a PSA 8.5 and told to get an biopsy. Parents both died of cancer so higher chance of developing same. Did some checking around and found an urologist in Tucson that does the procedure every week. He does 2 to 3 each week. And another urologist in his group does the same. This group has a total of 3 locations with other urologists also doing the same procedure. So First: if you live in a relative small town with a doctor that does these procedures once in a while, get on the Internet and find a place that specializes in urology. You want a doctor that does these things all the time where it is a “walk in the park” for him. So my experience: I had the same misgivings as many listed above me. Get Over It! That’s what I finally told myself. My wonderful experience: was led into a small room where the nurse told me to take clothes off from waist down and to leave socks on if I wished. Told me to lay on my side in fetal position with my butt facing a small monitor. She gave me a shot in one of my cheeks as additional antibiotic to oral ones I had been taking. Doctor came in and began as if he were getting into a car and starting the motor. Said this is going to hurt a little as I have a stenosis. All I heard was hurt and braced myself. And after entry with a 12 foot camera, just kidding, pain was gone. Then my mind drifted to the word stenosis. Ah, he means I have a tight ass. No wonder, small anal orfice. Never knew that before, but who ever looks back there. I have to tell you. I felt almost zero pain for the actual procedure. Barely felt the lidocaine he gave to numb prostate and then the biopsies where I felt nothing. He would say biopsy and a snap sound. And then we discussed basketball as if we’re sitting in lawn chairs having a beer until the next biopsy, snap.. Procedure was less than 10 minutes, more like five. Doctor left room and nurse said get up slowly as you might feel woozy. Nope, no wooziness. She left room and I went into bathroom to clean up with lots of blood around my butt. Sorry, but worth knowing. I was then alone wondering is that it? Put my drawers back on and left room. Some mild discomfort not bad at all. Lidocaine started to ware off 30 minutes later as I was driving home. An hour later it was a dull pain around my rectum. Two hours later it was almost no pain but a little uncomfortable. Two days later with blood in urine. And waiting for results which I will deal with . So the moral to the story. Get on the Internet and find a Urologist that looks good that does this all the time. But Get It Done Friend if you believe it is necessary. Sure some people will have problems but that’s life. Good luck to you amigo and hang in there.

  34. Raymond,

    Although your post was for Lionel. I appreciate your comments. You make absolute sence in your last statement.
    I have yet to get the results from my Biopsy. But rest assured I will do extensive research before committing to anything. Men should not just get done what the Urologist says without a 2nd or maybe 3rd opinion. Many men live with prostate cancer of some form well into there 80s or 90s.

  35. Lionel: Please do not rule out Active Surveillance. My experience is like yours…a diagnosis of cancer with a Gleason 6. My initial options were prostatectomy , described as the “gold standard” by my physician, and CyberKnife. My cancer is confined and small, as defined by CT scan and MRI. Through self education and a second opinion via MD Anderson I elected AS and don’t regret it for a minute.

    Please read every authoritative source before you commit to surgery or radiation. It is not stretch or truth that invasive prostate therapies have been overly prescribed, not only because of fear of liability but for a very convenient and risk free income stream, while subjecting countless males to ED, incontinence and bowel issues. Slow growing cancers in males are common and statistically not likely to result in mortality (typically caused by other issues).

  36. David here. Age 55.

    PSA level has been up and down like a pair of street walkers knickers.
    Highest was 7.8. Last one was 5.7. Urologist suggested a 2nd biopsy.
    I had one done 2 years ago but the Lab screwed up the results.
    (Long story, not only me but 9 other guys with the same lab work).
    I also had a urine test called a PC3 test just 3 weeks ago.
    Pee into a plastic container then they transfer it to a vile for processing. (Chemicals inside vile)
    It came back with a reading of 66. My urologist was not sure how they come up with this reading.
    I’m in the process of searching out my options. (That’s if I need to). I have not yet got my results of the 2nd. Biopsy.
    But I will post results for those whom are interested. I am in Calgary, Canada.
    So certain procedures in the United States as to biopsy procedures may vary.
    I did not find the procedure all that painful, (I’ve had it done twice now) they numbed the area where the needle goes through the rectum wall.
    The 9th and 10th “snap” were the most uncomfortable. Had 12 done this time, 6 on the left 6 on the right. If you have read this far and have yet to
    have a biopsy done don’t worry too much. I have had worse experiences in a dentist’s chair than this.
    Before you know it, it will be over. Other than hopefully the recovery.
    I still have slight pinkish bleeding at first urination after 6 days. I think this is the norm. But I’m keeping a close eye on it.
    I have read many of those postings, some are very comforting knowing that we are all going through this process that none of us want to.
    Good luck to everyone here and beyond those posts.

  37. I am 67 and have just experienced my first prostate biopsy. I was very nervous about the procedure prior to the office visit. The initial part of the procedure was uncomfortable but not painful. The only pain was what you would expect a shot should be. There were twelve biopsies taken, six on the left where the suspicious lump was and six on the right. The six on the right were not painful at all, just a little uncomfortable. However, the six on the left were painful. On a scale of 1 to 10, 10 being the most painful, I would say my level of pain was a seven on the left and 3 on the right. I would say that all in all the total experience was tolerable. Now I am experiencing a slight hint of blood in my urine and notice that there is some pain associated with my prostate when I unrinate and it is a little more difficult to get started. I don’t have my biopsy results yet and plan to update this post when I get the results.

  38. I am over sixty years and have always prided myself of having good health-low cholesterol and fasting blood sugar levels;normal heart and other organ functions.Anyhow,last year I decided to take a PSA test together with a Prostate digital examination.The Digital revealed a smooth surface and soft prostate.On the other hand, the PSA reading was 14ng/ml.Knowing the normal range is 0 -.4ng/ml,I felt the lab made a mistake(a case of denial).I repeated the Digital exam with two other Physicians who confirmed the first examination.
    Early in Jan.2013,I did another PSA test at a different lab and the readings went up to 19ng/ml.I immediately hoisted a red flag and visited a urologist who ordered a biopsy of the prostate.Twelve samples were taken.The first five were ok but the others were like being on a roller coaster ride that you wished could finish.The after effects were similiar to the other commentators above but milder.
    The results of the biopsy are in:Of the 12 samples taken,eleven were negative and one positive.I have also done a Ct scan of the pelvic region which has shown that the cancer is confined to one core of the Prostate Gland and has not migrated to other parts of the body.
    My Urologist has suggested two treatment options.
    (a)Radical Prostatectomy or
    (b)Brachy Therapy.
    Since the treatment option decision is mine to be made ,I am familiarising myself with the literature on the subject so that the the best option is taken.As with any medical condition, early diagnosis is important but we must do the necessary screening.”God” is good!

  39. Had a high psa which went down on taking a supplement – thought I’d dodged the bullet, but switched suppliments and it went back up. To get insurance, wife insisted I comply with Doc’s recommendations; doctors aren’t generally friendly toward alternatives to their training. . To my pleasant surprise, it wasn’t painful for at least 12 shots, but two days later, though no pain, have blood issues matching most mentioned here. I have no expectation of malignancy, the RNA marker test showed me clean and I avoid cancer inducing foods or habits. The main reason I post is to share that I was worried about the procedure being painful and it wasn’t – no pain management was involved. No doubt the doc’s skill was an important factor.

  40. John:

    I was horrified at the bright red semen but it seems after doing a little research on-line that this is fairly common.

  41. Great website……I’m 62 and I have been watching my PSA count of course over the years. Usually its been around 2.5 but once it jumped to 5.2 or so. I also have BH which is another story. The doctor advised me to go have a biopsy. After reading everyone’s post ….it seems I had a mild reading and only once. My doctored encourage me to go wih the biospy and I’m glad I did…however, they put me totally out. I don’t think I could do it any other way. Its been three weeks since the surgery. I too have had the same problems…..with some pain when I urinate….but getting past that but still sometimes have blood in the beginning of urination. But pretty much over it as well. My only problem now is when I ejaculate is the dull red blood. Lots of it…….which makes me not want to do that chore any more. I’ve read some places it take up to three months for this to go away. I haven’t ready too many comments how long it takes to go back to being creamy white. I miss those days. However, I’m thankful, my test came out negative overall. I still have BH…but they tell me now that Cialis (30 day pills) can strink your Prostate vice using typical prostate medication. Cialis does the same thing to the prostate. Who wouldn’t want to use this approach when you can be ready when she is….anytime after the bloody mess dries up. Check it out. I don’t think more you ejaculates solves the problem or clean out the pipes. I think its simply a matter of time. Any comments on that situation. Common sense says that but I don’t know. I just want to be normal again. All the best to everyone.

  42. Had the biopsy a week ago Tuesday, due to a rapid PSA elevation (doubled in 3 months, but still relatively low), and since I’m on hormone therapy, Dr. didn’t want to take any chances. As he put it, “as a cover my ass recommendation…” My experience: Never any blood in urine of stool. But semen is another story… in fact it was like a Stephen King novel… Gross and Frightening! 2 days after the biopsy, 1st ejaculation: Solid Bright Red, as if there was NO semen at all! A few times during the past week: a nasty brown color. Never thought I’d say this, but looking forward to “white” semen again. BTW- Results were narmal. Thank God! Oh, and I had it done with only a “local” anesthetic(?). …Never again. I too would recommend being “put out” for this. It’s not REAL painful, but EXTREMELY uncomfortable. I would say, “tolerable”, but “barely”. Good Luck to all you guys. And I hope this was helpful. Fred

  43. Just an FYI!! The bleeding, or should I say the spots of blood in my underwear, stopped after 3 weeks. My good news is no cancer but an inflammation. If your PSA is rising, ask for the antibiotics before the biopsy; that’s the standard of care, not the biopsy!!

  44. I am great full that this site exists. Reading all of the comments here helps. Just a few thoughts. If the doctor recommends it, have the biopsy. It is not a fun procedure, but tolerable. And it usually lasts less than 15 minutes. They tell you there will be blood in the urine and stools, and you will see varying degrees of that. The first ejaculation was mostly blood and scared the hell out of me. Luckily I found these postings minutes later and felt better. Your health is important. Do what it takes to be around for your loved ones.

  45. I’m 56 years old. Just had my biopsy 2 days ago. This was so uneventful that it borders on boring. Took the antibiotic the day of and a quick fleet anema. No big deal. I was put under for this procedure with a light anesthetic. Please insist on having the procedure done this way. I felt nothing at all. 20 minutes later I was in recovery eating cookies and drinking a soda and laughing with my brother. Why a doctor would perform this on a patient with out anesthesia is beyond me. I am seeing blood while urinating but I was told to expect this. I’m waiting on the results right now but not worried about this. I can’t stress to you enough, please have this procedure performed while you are under anesthesia. If your doctor does not do this please find a doctor that does. There is no other way. Good luck guys.
    Tom

  46. had my second biopsy in 7 months on december 18. extremely unpleasent/painful for me even after taking .01 mg lorazepam. also pretty much blacked out after procedure. i think due to the stress i put myself under. actually seeing blood in urine now more frequently. not lots but often. i am told this could last a few weeks, but do not see anyone in this forum with similar symptoms. anyone experienced blood in urine after biopsy for more than two weeks? good news is biopsy results were better that the earlier one. thanks.

  47. I think the driving for an hour afterward was the thing that tipped the pain to “super excessive”.
    Oh, the pain in the gut seems to be centered around the prostate area.
    I would say the doctor should have handed me acetaminophen as I left the office – so it would be at the ready. (Had to search the office floor for the drug while trying not to show any sign of discomfort. Quite a task! Fortunately, the pain would subside for a couple of minutes, so I could fake slight discomfort.)

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