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Thread: Prostate Biopsy AND Cystoscopy

  1. #1
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    Prostate Biopsy AND Cystoscopy

    Well I guess the title sort of says it all. In a couple of weeks I am scheduled to have a cystoscopy (for blood in the urine) and a prostate biopsy (family history of PCa, PSA of 11, African-American) on the same day - back to back. I will be sedated with a benzodiazepine and will receive local anesthesia. I'm wondering if this seems like a lot to you to have both of these procedures together), or if anyone has gone through having these back to back like that. I'm not looking forward to it to say the least.

  2. #2
    A prostate biopsy is 20 minutes at most, cystoscopy is less than that.

    I felt like crap for several hours after my biopsies, and I wasn't sedated at all.

    I would get them both at the same time, save a trip, get your diagnosis a little quicker.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3, PSA test 7/2019 2.0


    DOB 1956, in Pittsburgh, USA

  3. #3
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    Quote Originally Posted by Southsider View Post
    A prostate biopsy is 20 minutes at most, cystoscopy is less than that.

    I felt like crap for several hours after my biopsies, and I wasn't sedated at all.

    I would get them both at the same time, save a trip, get your diagnosis a little quicker.
    Thanks for your response, Southsider. Your point about getting the results back quicker by having them both done at the same time is a good one. And indeed, it does same me a trip back.

    Cheers!

  4. #4
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    I've had both,although not on the same day. They're unpleasant but not terribly painful, at least in my case. I agree with Southsider, get them done and out of the way.

    Good luck, man - keep us posted!
    Born 1953.

    10/11/18: TRUS biopsy: G6, 2 pos cores of 12.

    12/6/18: 1.5T mpMRI: 15.5mm diameter mass; "This is considered a PI-RADS category 5 lesion"

    1/4/19: UroNAV biopsy: G6 tumor 10% in 1 of 6 cores; uro recs treatment

    2/27: Dr. Epstein - G6 on single UroNAV core; 20%

    3/26: Color Doppler Ultra with Dr. Duke Bahn; recs AS.

    5/6: 2nd opinion from Kaiser uro; recs AS.

    6/7: Dr. Clayton Lau at City of Hope recs AS.

    7/8: 3rd opinion at Kaiser: AS.

    7/15: Dr. Leonard Marks at UCLA: AS. Their radiologist finds nothing abnormal in MRI. Prostate vol is 33g.

    PSA
    8/2/18: 1.2
    3/26/19: 1.8
    6/14/19: 2.2

  5. #5
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    Quote Originally Posted by Skipper Chuck View Post
    I've had both,although not on the same day. They're unpleasant but not terribly painful, at least in my case. I agree with Southsider, get them done and out of the way.

    Good luck, man - keep us posted!
    Chuck - Thanks for sharing your experience with me and for the good luck wishes. I'll let you know how goes.

    Max

  6. #6
    Moderator Top User HighlanderCFH's Avatar
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    As with the others, I have had both, but not on the same day. I had minimal (basically none) pain during my 20 core biopsy because the doctor numbed both the rectum and prostate.

    The day prior to my surgery at Mayo, my surgeon did a cystoscopy. Make sure they use a FLEXIBLE probe as my doctor did. They shoot a numbing agent in before starting and I really felt nothing at all. As I recall, the exam only took about one minute and it was over.

    I don't see it being any huge deal to have both the biopsy and cysto done on the same day.

    I think you will get through this just fine!
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  7. #7
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    I had both on the same day. The most unpleasant part was waiting for it to begin. I waited over an hour for the Dr after the nurse had applied numbing gel in both areas.
    Born 1952
    PSA went from 1.9 in 2013 to 3.4 in July 2015
    8/14/15 DRE found lump
    9/25/15 Biopsy
    12 samples,4 samples were Gleason 6 (3 + 3)
    Scan of Abdomen and bladder clean
    11/13/15 DaVinci Robotic Surgery performed
    Gleason score upgraded to 7 (3 + 4)
    Tumor involved 45% of prostate
    Margins negative for malignancy
    Perineural Invasion:identified
    Two Lymph nodes: Negative for malignancy
    Pathologic staging: pT2c pN0
    PSA 12/11/15: 0.01
    PSA 03/04/16: 0.00
    PSA 06/28/16: 0.00
    PSA 10/22/16: 0.00
    PSA 02/03/17: 0.00
    PSA 05/18/17: 0.00
    PSA 08/31/17: 0.00
    PSA 12/14/17: 0.00
    PSA 07/13/18: 0.00
    PSA 01/08/19: 0.00
    PSA 07/02/19: 0.00
    AMS 700 CX penile implant 11/30/18

  8. #8
    Regular User
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    Quote Originally Posted by Maximus View Post
    Well I guess the title sort of says it all. In a couple of weeks I am scheduled to have a cystoscopy (for blood in the urine) and a prostate biopsy (family history of PCa, PSA of 11, African-American) on the same day - back to back. I will be sedated with a benzodiazepine and will receive local anesthesia. I'm wondering if this seems like a lot to you to have both of these procedures together), or if anyone has gone through having these back to back like that. I'm not looking forward to it to say the least.
    Technically, this seems to be more "front to back"....?

    Sorry, couldn't resist.

    I'm with everyone else, think getting both done on the same day makes sense, especially with the sedation. I also went through both (blood in urine too) without sedation; while both are not pleasant experiences, they're not that bad. Best of luck to you, please keep us posted.
    Age at DX: 58
    PSA: 4.9
    Positive DRE
    Biopsy: 12/7/15
    Left Mid
    Adenocarcinoma 1/12 cores (45%)
    Gleason 4+3=7, CT abdomen, bone scan negative
    RALP 1/27/16 at CINJ/RWJ (New Brunswick, NJ)
    Surgeon: Dr Isaac Kim (1400+ procedures, highly recommend)
    Final Pathology: 2/1/16
    7 lymph nodes, seminal vesicles negative
    Postero-lateral (neurovascular bundle) margin involved by invasive carcinoma
    Gleason score 5+4=9 with intraductal component
    Primary tumor pT2: organ confined, high grade PIN
    Four post-op exams: PSA <0.01

  9. #9
    Top User garyi's Avatar
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    Another recommendation to get them both the same day. Much more convenient, and will give the doc more data, faster.

    Not painful at all. At most - a bit uncomfortable. Treatment anxiety can be much worse than the procedures. You can control that. Good luck!

  10. #10
    Agree with all for same day,. Any of the mild symptoms after scoping will be the sililar to the post-biopsy ones, so just one combo procedure to get over
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3 -
    2013 TURP (90→30 g) path neg. then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day check)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015

 

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