I’m having one in a couple of weeks. I’m not expecting a walk in the park, but I’m assuming that since I’m allowed to drive myself home it can’t be too excruciating. Anyone who’s experienced one have an opinion?
I’ve had three, maybe four.
No, it’s not pleasant but not that big of a deal.
High PSA count but so far, no cancer, but definitely enlarged prostate.
I’ve got a lesion they’re checking out. I had an MRI first, so they should know where to go.
Definitely high on the Not Fun scale, but not painful. They inject a local anesthetic with the anal probe. No other drugs or painkillers that might inhibit your ability to drive. The whole process took maybe 15-20 minutes.
So not too different from a run of the mill alien abduction? 
I probably shouldn’t post this in this thread, but I have a very deep grudge against my PCP and the specialist for this unnecessary and damaging procedure. If OP does not want to read more, he shouldn’t.
I don’t know how this part was for other people, but for me those jabs with a needle were exquisitely painful, if only for a short time. The prostate does have nerve endings, I presume. By the time the 12 (or was it more? I don’t remember) samples were taken, the local anesthetic had taken effect. However, there were long-lasting consequences of all those tissue removals. Or maybe that was coincidence.
In my case, there was no MRI in advance, no evidence of lesions, only a slightly raised PSA level. The specialist did a very thorough (very thorough) manual exam a couple of times, and did not find evidence of any abnormality. Nevertheless he said a biopsy was necessary. I wish I had said no.
This is, as I said, different from the OP’s case, as he has a known issue that needs to be addressed.
Hope your procedure goes smoothly. Keep us posted on the results.
Signed, NWH, who does not have a prostate.
I’ve never seen the doctor adjust the anesthetic dose for the size of the prostate. If your prostate is the size of the NY bagel, the dose is inadequate and you will feel the samples outside the range of the anesthetic. It hurts.
Also, prostate biopsies are guided by ultrasound. Ultrasound requires gel. You will be, um, expelling gel for some time after the procedure. There will also probably be some bleeding. I recommend wearing disposable underwear for the rest of the day.
To expand on the above, at least in my case an ultrasonic “egg” was inserted where the sun don’t shine (it was used by the doctor to guide the probe). I don’t recall an anesthetic, but that may be because I had mine 12+ years ago; what I do recall is the sensation when the doctor took a sample — not exactly painful, more like a brief electric shock.
The other salient memory is constantly feeling that I was about to fall off the table since my tuchis was hanging out in midair. Maybe they’ve improved the table design; one may hope.
But — again, in my case — it turned out to be worth it since the biopsy identified a “high grade” tumor (I forget the exact Gleason score, but it was on the upper end). And based on post-op pathology, it would most likely have killed me in five or six increasingly miserable years. YMM (hopefully W) V.
Apparently there are 2 kinds of biopsy procedures: more invasive (in a hospital but out-patient) and less-invasive (in the urologist’s office), and I had the more-invasive version. Got a ride home in a few hours.
I woke up and my first groggy words to the recovery room nurse were “My butt hurts”, but it was actually mild and went away quickly. The only other after-effects were blood in my urine (at the beginning of the stream, then clear) which went away in a few days, and semen.
(results: I’ve got the very slow-growing type of prostate cancer, where they just monitor it. PSA tests every quarter, an MRI coming up and maybe another biopsy.)
Very unpleasant, but over quickly. But I came here to make a very important point. If at any time in the day or two after you feel any fever, run, not walk, to the nearest emergency room.
A friend, one of the finest mathematicians I have known, had a prostate biopsy around 2000. It was on a Friday and when he felt slightly feverish in the evening, he figured it could wait till Monday morning. By Monday morning, he was in terrible shape. He went to the emergency room, but the infection was rampant by then. His kidneys had shut down, for example. He survived, barely, for a few years, but spent it in a partial daze in a nursing home. He certainly did not fully recover. We never knew what, if any, instructions he had received. The biopsy goes through the anus and has a non-zero chance of picking up a bug on the way. I was aware of the story when I had mine, but I was fine. And you probably will be too. Just be aware of what can happen.
A bit of post biopsy FYI. The next time or two you ejaculate will possibly have blood in it. This is normal. You may want to ‘self service’ a couple of times to avoid alarming or squicking out your partner. Or yourself.
Echoing most comments above: it’s sharp enough to make you flinch, but the pain is fleeting. The biopsy needle makes a sound like a staple gun, and that was a little…interesting. This site was helpful
Good to know. I have an antibiotic to take beforehand, but I know they’re not 100% effective.
My partner isn’t likely to see it where it’s going. I’ll give her a heads up just in case, though.
I’d suggest wearing earplugs, or maybe jamming to some loud tunes during the procedure. The staple gun sounds aren’t comforting.
And you will have blood in the next few ejacs.
Maybe I’ll listen to Zappa’s “Broken Hearts Are For Assholes” on a loop while being thankful anything I may have wrong will be caught earlier than it was with Frank.
I’ve had two in the doctor’s office and one (MRI guided) in which I was put out. That one of course I didn’t feel a thing.
In my case (and you should be given a scrip for antibiotics before the procedure) the first two needles (felt like left and right) were the anesthesia. I remember feeling them but it wasn’t too bad. The doctor said that’s the worst of it.
After that, there was a snapping sound when a sample was taken, but there was really no pain. Maybe a quick feeling of pressure. It was over in a few minutes actually. I was sent home in a diaper.
As others have said, you may/will have blood in urine, semen and stool for a few days. I’m sure you will be informed of that. Good Luck!
I already have the antibiotic, and it looks like a horse pill.
Ask the doctor about giving you anesthesia such as propofol like they use for a colonoscopy. You will be asleep during the whole thing. I know a friend who has done this both ways, and he said he highly recommends the propofol. You will need someone to drive you home after it, because it is anesthesia. He’s a doctor himself and said there is no shame in having anesthesia and said his health insurance covered it too just like the rest of the procedure. It isn’t going to change the outcome if you are made to feel uncomfortable.