A prostate biopsy is a medical procedure that involves taking small tissue samples from the prostate gland to check for cancer. While the prospect of a biopsy often raises concerns about pain, understanding what to expect can help alleviate anxiety. Although some discomfort is anticipated during and after the procedure, significant pain is typically manageable through various techniques and medications.
Understanding Discomfort During the Procedure
A common type of prostate biopsy is the transrectal ultrasound (TRUS) guided biopsy, where a thin ultrasound probe is inserted into the rectum to visualize the prostate. A local anesthetic, such as lidocaine, is injected to numb the area around the prostate, reducing pain during tissue sampling.
Despite the anesthesia, patients often report feeling pressure from the ultrasound probe and the needle. When the spring-propelled needle takes tissue samples, a brief, sharp sensation, sometimes described as a “pinch” or “pop,” may be felt. This sensation is usually momentary for each of the 10 to 12 samples typically collected. While some individuals might experience mild pain, severe pain during the procedure is uncommon due to the local anesthetic.
Managing Pain After the Biopsy
Following a prostate biopsy, it is common to experience mild soreness, discomfort, or a dull ache in the rectal area or lower abdomen for a few days. Bruising may also occur. It is also normal to observe some bleeding.
Blood may appear in urine or bowel movements for up to two weeks, and in semen, it can persist for several weeks or even a couple of months, appearing red or dark brown. These instances of bleeding are minor and resolve on their own. Over-the-counter pain relievers like acetaminophen are often recommended to manage any post-procedure discomfort. Light activity is advised for 24 to 48 hours after the biopsy, and strenuous activities should be avoided for a few days.
Strategies to Reduce Discomfort
Medical professionals employ several strategies to minimize discomfort during a prostate biopsy. Urologists ensure adequate local anesthesia, often using periprostatic nerve blocks with lidocaine injected near the prostate to provide effective pain relief, particularly during needle punctures.
Patients can also take proactive steps to reduce discomfort and anxiety. Asking questions and understanding the procedure beforehand can help. Avoiding certain medications, such as blood thinners like aspirin or warfarin, before the biopsy, as advised by your doctor, is important to minimize bleeding risk. Deep breathing or relaxation techniques can also be beneficial during the procedure to help manage any anxiety or anticipatory pain.
When to Contact Your Doctor
While some discomfort and minor bleeding are normal after a prostate biopsy, certain symptoms warrant immediate medical attention. You should contact your doctor if you develop a fever of 101°F (38.3°C) or higher, experience chills, or have severe or worsening pain not relieved by over-the-counter medication.
Difficulty urinating, inability to pass urine, or heavy bleeding with large clots in your urine or from your rectum are also signs that require prompt medical evaluation. These symptoms could indicate an infection, significant bleeding, or acute urinary retention.