You may be reading this because you are about to undergo a prostate biopsy procedure, if so you are probably feeling anxious and maybe more than a little scared. I can write this article with some authority because I have been there myself. I won't forget in a hurry how my mouth went dry and stomach turned to water when a phone call from my doctor said they wanted to see me urgently about my prostate PSA levels results.
If you aren't already aware, the prostate is the walnut sized gland located above the rectum and just below the bladder in men. For most of our lives it serves a useful purpose alongside other sex organs producing semen. One of the drawbacks to this fellow is the way it wraps doughnut like around the urethra, the tube which allows the passage out of both semen and urine. The reason it can cause problems is because from middle-age onwards the prostate of most men naturally begins to enlarge. As it enlarges it constricts the urethra narrowing the opening and making it more difficult to pass water. If you are a fifty plus man who has to stand for five minutes in front of the toilet making faces out of the patterns on the wallpaper while trying to urinate, now you know why.
I had recently mentioned in passing a slight difficulty when urinating to my doctor who suggested a prostate PSA test. Prostate Specific Antigen is a hormone and while it's normal to have low levels of it in your blood, when the level rises it red flags something could be amiss including cancer. Because my results were much higher than normal I visited a male doctor who conducted a digital rectal examination. In direct speak he dons a rubber glove and probes your rectum with his index finger to feel the size and shape of your prostate. For all you guys wincing now, if the doctor discovers something suspicious, gets you treated and on the road to recovery I think that's worth a couple of minutes of embarrassment.
While the enlargement is a nuisance, it can be treated with drugs or a minor operation to ease the constriction. Of course there's the other main cause of prostate problems, cancer. Sadly it kills a lot of guys every year.
My doctor next referred me to a Urology consultant who again did the rectal examination but concluded the prostate neither appeared to be enlarged nor firmer and lumpy, all tell-tale signs of possible cancerous tumours. However due to the high reading of my PSA level, triple the expected for my age range, I was scheduled for a prostate biopsy. That statement came as a shock and was very scary because I was now staring at the real possibility that maybe I had cancer.
For any men who are about to undergo a biopsy of the prostate this is how mine went. Perhaps the procedure may vary a bit but I imagine they are all pretty much follow a similar routine. When I attended my appointment and the nurse checked my personal details, blood pressure etc I was instructed to change into a hospital gown. At the appointed time another nurse came to collect me and lead me to theatre. There followed more checks to establish I was the right person and questions about my health, then we were good to go.
The consultant injected a large dose on antibiotics into the vein on my hand. This is one leg of the precautionary procedure to combat infection, more about that later. I was given a brief run-down of what to expect and what the consultant would be doing to me. You will be asked to lay on your side with your knees drawn up to your chest. It might not be standard but I had a lovely friendly nurse sitting before me who chatted about anything and everything to distract me. In a quick run-down this is how the biopsy unfolded.
Yet another digital rectal examinationas the doctor checked physically the size and shape of my prostate. Next came the part I was probably dreading most, insertion of the probe that would take the biopsy sample. I understand that some consultants administer a shot of anaesthetic to your prostate to numb it. I honestly don't recall getting this but maybe the nurse distracted me. The probe wasn't painful just uncomfortable and alien. The actual probe itself not only fires a needle into the gland to take samples but also relays ultrasound pictures. This allows your specialist to guide the probe, examine things and take ultrasound pictures in the same way pregnant women get snaps of their baby in the womb.
Though I had been forewarned you can't help jumping in surprise when the samples are taken. It's usual for twelve samples, six from each side of the gland to be taken. The way this is done is a thin needle in the probe is fired deep into the prostate and a core of tissue extracted. If you've ever had one of those spring-loaded finger prickers diabetics use snap your finger for a blood sample you'll know how it feels. It's a sudden sting for a couple of seconds each time and that's all.
Once all the samples required have been taken you will likely get an antibiotic suppository pushed deep into your rectum. A further course of antibiotic tablets will have to be taken orally for about five days too. Now this seem like an awful lot of antibiotics but here's why. When the doctor fires the probe needle it has to puncture the wall of the rectum to penetrate your prostate. This action inevitably carries the likely risk of transferring bacteria from what is obviously a very dirty and germ loaded area to inside of your body. A few people will suffer infection but the risk level is small.
After a short recovery period of maybe an hour the nurse may require you to urinate to check your bladder function and rate the blood loss. It should be explained to you to expect blood in your urine for a couple of days and more particularly blood in the semen for up to six weeks. If you are at all squeamish there will seem to be a lot of blood in your first few ejaculations. The blood loss should diminish over days and weeks.
For a few days after your prostate biopsy procedure you will be sore and you may experience a dull ache down below but within three or four days it should have worn off. The only thing to concern you next is the test results themselves. In my case I got the all clear, great news! Kind of, no cancer detected. Note the statement was, no cancer detected, that's not quite the same as no cancer exists.
Although my PSA reading have dropped in subsequent tests it remains double what it should be. The prostate PSA test is notoriously inaccurate and many men are undergoing the prostate biopsy procedure needlessly. Bizarrely all kinds of things can skew the test results. Men who cycle a lot can register high reading of PSA and should you have sex and ejaculate within 24 hours of a test, the Prostate Specific Antigen levels will be abnormally high. There are no easy answers, men with high readings might not have cancer but at the same time cancer might be growing but the test results can be well within accepted ranges. There are many concerns that having PSA tests done causes unnecessary anxiety because they are so unreliable but until a better test comes along, it's the best we have.
Do I regret having the biopsy done? Not for a second. Even though the results so far are inconclusive, if anything sinister was present there's a good chance it would have been found and the earlier the treatment the better. Any procedure, even having a tooth extracted carries risk, it's a balance you have to weigh up yourself. I wanted to write this article to inform and educate other men who will find themselves in the same position as me. If you have to face this thing like I did, don't ignore it hoping it will go away, it won't. If you are having prostate problems, bite the bullet and see your doctor because it might be potentially life threatening.
For the forseeable future I am on 'watchful waiting'. So we watch and wait.
If you aren't already aware, the prostate is the walnut sized gland located above the rectum and just below the bladder in men. For most of our lives it serves a useful purpose alongside other sex organs producing semen. One of the drawbacks to this fellow is the way it wraps doughnut like around the urethra, the tube which allows the passage out of both semen and urine. The reason it can cause problems is because from middle-age onwards the prostate of most men naturally begins to enlarge. As it enlarges it constricts the urethra narrowing the opening and making it more difficult to pass water. If you are a fifty plus man who has to stand for five minutes in front of the toilet making faces out of the patterns on the wallpaper while trying to urinate, now you know why.
I had recently mentioned in passing a slight difficulty when urinating to my doctor who suggested a prostate PSA test. Prostate Specific Antigen is a hormone and while it's normal to have low levels of it in your blood, when the level rises it red flags something could be amiss including cancer. Because my results were much higher than normal I visited a male doctor who conducted a digital rectal examination. In direct speak he dons a rubber glove and probes your rectum with his index finger to feel the size and shape of your prostate. For all you guys wincing now, if the doctor discovers something suspicious, gets you treated and on the road to recovery I think that's worth a couple of minutes of embarrassment.
While the enlargement is a nuisance, it can be treated with drugs or a minor operation to ease the constriction. Of course there's the other main cause of prostate problems, cancer. Sadly it kills a lot of guys every year.
My doctor next referred me to a Urology consultant who again did the rectal examination but concluded the prostate neither appeared to be enlarged nor firmer and lumpy, all tell-tale signs of possible cancerous tumours. However due to the high reading of my PSA level, triple the expected for my age range, I was scheduled for a prostate biopsy. That statement came as a shock and was very scary because I was now staring at the real possibility that maybe I had cancer.
For any men who are about to undergo a biopsy of the prostate this is how mine went. Perhaps the procedure may vary a bit but I imagine they are all pretty much follow a similar routine. When I attended my appointment and the nurse checked my personal details, blood pressure etc I was instructed to change into a hospital gown. At the appointed time another nurse came to collect me and lead me to theatre. There followed more checks to establish I was the right person and questions about my health, then we were good to go.
The consultant injected a large dose on antibiotics into the vein on my hand. This is one leg of the precautionary procedure to combat infection, more about that later. I was given a brief run-down of what to expect and what the consultant would be doing to me. You will be asked to lay on your side with your knees drawn up to your chest. It might not be standard but I had a lovely friendly nurse sitting before me who chatted about anything and everything to distract me. In a quick run-down this is how the biopsy unfolded.
Yet another digital rectal examinationas the doctor checked physically the size and shape of my prostate. Next came the part I was probably dreading most, insertion of the probe that would take the biopsy sample. I understand that some consultants administer a shot of anaesthetic to your prostate to numb it. I honestly don't recall getting this but maybe the nurse distracted me. The probe wasn't painful just uncomfortable and alien. The actual probe itself not only fires a needle into the gland to take samples but also relays ultrasound pictures. This allows your specialist to guide the probe, examine things and take ultrasound pictures in the same way pregnant women get snaps of their baby in the womb.
Though I had been forewarned you can't help jumping in surprise when the samples are taken. It's usual for twelve samples, six from each side of the gland to be taken. The way this is done is a thin needle in the probe is fired deep into the prostate and a core of tissue extracted. If you've ever had one of those spring-loaded finger prickers diabetics use snap your finger for a blood sample you'll know how it feels. It's a sudden sting for a couple of seconds each time and that's all.
Once all the samples required have been taken you will likely get an antibiotic suppository pushed deep into your rectum. A further course of antibiotic tablets will have to be taken orally for about five days too. Now this seem like an awful lot of antibiotics but here's why. When the doctor fires the probe needle it has to puncture the wall of the rectum to penetrate your prostate. This action inevitably carries the likely risk of transferring bacteria from what is obviously a very dirty and germ loaded area to inside of your body. A few people will suffer infection but the risk level is small.
After a short recovery period of maybe an hour the nurse may require you to urinate to check your bladder function and rate the blood loss. It should be explained to you to expect blood in your urine for a couple of days and more particularly blood in the semen for up to six weeks. If you are at all squeamish there will seem to be a lot of blood in your first few ejaculations. The blood loss should diminish over days and weeks.
For a few days after your prostate biopsy procedure you will be sore and you may experience a dull ache down below but within three or four days it should have worn off. The only thing to concern you next is the test results themselves. In my case I got the all clear, great news! Kind of, no cancer detected. Note the statement was, no cancer detected, that's not quite the same as no cancer exists.
Although my PSA reading have dropped in subsequent tests it remains double what it should be. The prostate PSA test is notoriously inaccurate and many men are undergoing the prostate biopsy procedure needlessly. Bizarrely all kinds of things can skew the test results. Men who cycle a lot can register high reading of PSA and should you have sex and ejaculate within 24 hours of a test, the Prostate Specific Antigen levels will be abnormally high. There are no easy answers, men with high readings might not have cancer but at the same time cancer might be growing but the test results can be well within accepted ranges. There are many concerns that having PSA tests done causes unnecessary anxiety because they are so unreliable but until a better test comes along, it's the best we have.
Do I regret having the biopsy done? Not for a second. Even though the results so far are inconclusive, if anything sinister was present there's a good chance it would have been found and the earlier the treatment the better. Any procedure, even having a tooth extracted carries risk, it's a balance you have to weigh up yourself. I wanted to write this article to inform and educate other men who will find themselves in the same position as me. If you have to face this thing like I did, don't ignore it hoping it will go away, it won't. If you are having prostate problems, bite the bullet and see your doctor because it might be potentially life threatening.
For the forseeable future I am on 'watchful waiting'. So we watch and wait.
