In general, if a biopsy is received by the lab before late afternoon (say, 4 o’clock), it’s processed and slides go to the pathologist by the next morning. With an uncomplicated diagnosis, results are available to the referring urologist by the end of the day. So, routinely less than 36 hours turnaround time. Getting immunostains and second opinions may prolong things.
How fast the referring doc’s office communicates the diagnosis to the patient is up to them.
Regarding pain (everyone’s MMV I suppose): I had a biopsy maybe 15 years ago, before they had MRIs that could be used for prostate readings. The only real pain was the two or three shots into the prostate for local anesthetic (done by the same gadget that took the samples), which I found excruciating but brief. The anesthetic worked well enough that I did not feel any pain at all from the samples, of which there were (I think) 12 – there was nothing to go on in terms of location so the doctor said he wanted to be very thorough.
I think I got the readings within about 3 days. It was completely negative. Also my PSA went down the next time it was taken, so I elected to stop going to the specialist, and my PCP adopted a keep testing and wait and see attitude.
About 3 years ago my PSA started rising again so I went to a different urologist, and he sent me for an MRI, which was inconclusive. My PSA continued to rise slowly, and then it spiked, so I am going in for another MRI on Wednesday. My current urologist does not seem eager to do a biopsy, but if there is anything new in the MRI or if my PSA continues high, he will probably want me to have one. All I can say is, ugh. My age (almost 76) may be a factor as well.
(TMI follows – shortly after that biopsy 15 years ago, my ejaculate disappeared. I hope that doesn’t happen to the OP, it’s kind of a downer.)
Before ramming the dildo like (with something looking like a gun hanle) up my butt, I heard him fiddling with something, turned around and saw him rolling a condom onto the thing. “Condom?” said I. “Yeah. Is it the firs time you have a condom up your arse?” he replied.
The experience also led me to believe that people who practice anal sex must enjoy pain a lot more than I do.
even more TMI
That’d be retrograde ejaculation. Happened to me when they removed the sigmoid colon. Indeed a bummer, but would’ve been a lot worse had I been younger.
Best stay out of medical threads in general going forward, then. I can think of a lot grosser possible TMI subjects we’ve discussed in these sorts of threads before.
I was about 68, IIRC, that my PSA went up suddenly to 9. They did a biopsy and there was no cancer. A new PSA came down a bit to 7, and my GP recommended no more PSA and I happily agreed. That GP retired around 2021 and I was assigned a woman who ordered a PSA test (although I didn’t know that). The PSA reading was 11. She insisted I see a urologist who said that he didn’t take a PSA seriously for an 84 year old until it hit 20, then amended that to 30. He did a perfunctory rectal examination and sent me on my way. The biopsy itself was one of the more unpleasant experiences I have ever had.
Let me tell one other story. Whoever does the procedure will emphasize that if you have any fever or any other sign of infection after the biopsy head immediately, if not sooner to the nearest emergency room and tell your story. Follow this advice.
There was a mathematician I knew well who had a prostate biopsy on a Friday. By that night he was running a fever. He figured he didn’t want to spend the weekend in an emergency room and could wait till Monday morning. On Monday he went to the emergency room. He nearly died. His kidneys had closed down and there were other problems. He never recovered and died in a long-term care facility 2 or 3 years later. Never proved another theorem.
After elevated PSA, followed by an MRI, I had a biopsy done 4 years ago. Under general anesthetic so no pain at all. And blood in urine & semen for a while, which is disconcerting.
My particular diagnosis is as good as it gets: it’s the kind that you’ll live with until you die of something else. I had quarterly PSAs for the next 2 years, now just annual. Numbers are consistently in the 4.0 - 5.0 range, and my urologist is happy. (We discussed whether or not men over 70 should get tested at all. She and I are happy to go against the AMA advice and continue testing – my peace of mind is improved by testing, not made worse.)
It did not work that way for me. I’m not going into detail here, there’s a limit on how much I am willing to share, but no, it does not feel anything like as good as it did before.
When most of us have this problem, it is hard to tell if any issues come from the procedure or from age. I’m in good shape, but let’s say I’m glad that certain pills are quite cheap at Costco.
I’m reminded of a long-ago New Yorker cartoon showing two older gents in an old-fashioned men’s club, sitting in comfortable easy chairs in front of a fireplace. One is saying “If I hear the word prostate in here one more time, I’m resigning!”
I haven’t participated in this thread because IANAD and I only contribute to medical threads when I have first-hand experience. But I can still wish you the best tomorrow, and say that you’re a better man than I for being relatively stoic about pain – it’s not that the biopsy is necessarily that big a deal, it’s that I’m a total wuss! I pray to God I never get a kidney stone!
Good luck tomorrow, and remember, PSA results that are positive are overwhelmingly false, so much so that the Ontario public health care system no longer pays for them.
The countdown, followed by the waiting, no matter how short, is just going to suck. You have my complete sympathy. I won’t be be so Pollyanna as to say you have nothing to worry about and it’ll all be fine, but I’m confident that you’ll be able to take the news, good or bad and make plans either way.
Best of luck tomorrow, @What_Exit. I posted a bit about my experiences in the linked thread, and I encourage you to read it at your leisure. I found a lot of helpful info on every stage of the process.
As for the biopsy…ugh. On edit, I’m spoilering this. If more info helps you feel better about the process, go ahead and read it. If me sharing a not fun experience will stress you out, save it for after the procedure.
Summary
To prepare you, and hopefully not just scare you, mine was absolutely miserable. Since you had an MRI, I assume it will be an MRI-fusion biopsy, where they use the MRI results to target specific areas of the prostate, in addition to the general quadrants they sample. This means they insert the ultrasound wand, map everything out, then you lie there with a large dildo in your butt while they “fuse” the ultrasound map to the MRI image. That took maybe 20 minutes for me - definitely a bit uncomfortable, but not really painful. I was instructed to keep absolutely still throughout or they’d have to remap everything.
Then you get the shots to numb the prostrate. I think I had three. These are very painful, but very brief.
Then they start taking samples. They took 12 standard samples, plus 5 extras based on lesions seen in the MRI. The doctor said it would feel like a little poke and a pinch. But I think the anesthesia was not well distributed throughout my prostate.
The first samples were as described - mildly uncomfortable, but tolerable. But after the halfway point, it started to get decidedly painful to the point I was really dreading the next. And the last few were excruciating. It felt exactly like what it was - a giant needle being shoved deep into me, and then a thick core of tissue being ripped out. I almost popped the stress ball they gave me, I thought I was going to throw up when it was done, and when I got home, I had to lie down for the rest of the day.
To try to end on a happy note: it sounds like mine was worse than most of the other people posting here, and as bad as it was, I got through it and it’s over. With luck, you’ll do better than me. So I wish you lots of it. And hopefully this is the last step for you and things come back clean.
And just to emphasize this - QtM doesn’t mean a little pink tinge. It’s more like strawberry jam.
