What's next? Trans-rectal, ultrasound-guided biopsy

Fate sometimes, conspires, doesn't it? I was away on business for the next few days so didn't receive the urgent first-class posted letter that had dropped through my door, only a couple of days after the MRI scan. Not having received it, I was a bit gob-smacked to get a phone call from a lady wanting to confirm my appointment for a biopsy.

"Er, what biopsy?"
"You've not had the letter?"
"Nope, I'm in Birmingham at a conference."
"Your MRI results are showing a shadow on the prostate and Mr Smith (name changed) has decided you need to have a biopsy."
"I see."


This was not news that I was wanting to hear and especially not during the coffee break at a very busy conference. She gave me the planned date and that looked OK, so Gloria and I sat down and discussed what was going to happen.

"It's a trans-rectal, ultrasound-guided biopsy."
"Words of one syllable, big boy."
"They stick an ultrasound probe up your bum that lets them see where the biopsy needle goes."
"OK - got that. Trans-rectal: up the bum. Ultrasound-guided: using a scanner thingy. And the biopsy bit?"
"They pass a needle up the probe to inject you with anaesthetic, then they use a biopsy needle to take samples from specific parts of the prostate."

Sounds easy. And it was, in fact. Very easy ... for the consultant radiologist doing it. Let's not beat around the bush here, so to speak. It hurts a bit - not a huge amount. And it's very uncomfortable.

It unfolded like this. Gloria and I arrived at the hospital, she with laptop in hand, me with heart in mouth. We sat and waited for a little while in the outpatients department until I was called through. Wisely, Gloria stayed put, tapping furiously.

The nurse who took me through was chatty, bright and reassuring. She was lovely. And the consultant radiologist could not have been more solicitous or attentive. You know by both those facts that you're about to have something fairly major done to you. However, first of all, it was the fashion item gowns again and a handy bag to stow your clothes in.

This was a lie on the table and clutch your knees job. The probe went in - not too bad - uncomfortable rather than anything else. He wiggled it about a bit until he got a picture he liked and then told me that he'd already injected me with the anaesthetic. Didn't feel a thing.

"You'll hear a click like this," [click] "every time I take a sample. OK?"
"Yup"

And so it progressed. At this point, the nurse became very chatty and deeply interested in where we lived, what we did, how we spent our time, children, grand-children, favourite films, books, the weather - a constant stream of chatter that distracted me beautifully from what was going on [click] in my nether regions.

Ten [clicks] later, he'd finished - I had only expected about five, so I was surprised. He had taken ten samples from throughout the prostate and these would now be sent off for analysis and I would hear the results in due course from the Urology team.

The kindly nurse, dutifully wiped my bum for me - thank you so much! - and I was told to sit up very slowly and not try to stand. I was glad of that advice because I did feel a bit swimmy after having been interfered with so comprehensively. I bade them farewell and lurched back into the waiting room where Gloria was still thumping her keyboard as if it had somehow upset her.

She looked up.

"Oh heck. Do you want to sit down?"

I was as white as a sheet and I indicated that what I needed was to get in the car, go home and lie down for a little while. The little while actually turned into two days of dozing and drinking cups of tea. Gloria just did everything and left me alone to recover.

Now, you need to know about the side effects, because there are some. You need to watch out for potential constriction of the urethra, if the prostate swells as a result of the biopsy. This would make you have difficulty peeing. Also, there is the chance of infection, but you are given powerful antibiotics (Ciprofloxacin, if you're interested) to take before and after the procedure.

You are warned that you may have blood in the urine - I didn't - or in your stools - uh-uh. However, when I had got back to something approaching normal functioning, there was blood in ... well, Gloria reckoned it made her look as if she was having a period. That lasted for around four weeks, diminishing as time went by.

Otherwise, it slowed me up a bit on the sex front. There was a lack of urgency from the controlling mechanisms, but everything still functioned reasonably well. That slow-down effect passed away along with the blood.

All the way through this process there are leaflets, instructional talks and more from the staff attending to you. And, if you need more advice, you can contact the specialist nurses at Prostate Cancer UK who can support you with all aspects, from treatment options to side effects. (Call 0800 074 8383 until 6pm) or visit their website.

Then we waited.