WHAT A CROCK!

[Horheh]

The American Urological Association (AUA) seems numb (pun intended) to the anesthetic options for the barbaric intra-rectal prostate biopsy.   Reading about sedative alternatives to the excruciating pain of gun-fired biopsy infuriates me as a patient:  No one discussed this possibility with me before my (NO ANESTHESIA) multiple sample procedure yesterday!  Once and for all, the AUA needs to set the standard of care as short-acting general intravenous anesthetic agents (spare us your asinine argument about the point score efficacy of injectable lidocaine via different sites).
PLEASE also stop lying to men saying that you may experience “discomfort” when the biopsy is taken:  This is an incredibly PAINFUL procedure.
Come out of the dark ages!  Spread the word guys:  DO NOT go to a urologist who doesn’t offer sleep for this procedure!



This discussion is related to Recent prostate biopsy.

[Horheh]

Thanks for your comments, Shelly!  If we used these procedures without anesthesia on enemy combatants, there'd be no doubt that water boarding is not torture!  The Taliban would surrender.

Sorry for your experience, ‘pray you heal and find another urologist!  Here’s the truth:

• Most urologists are motivated by what most physicians are:  The almighty dollar.  If they include sedative/sleep anesthesia in a procedure, it costs them more ('gotta monitor the patient closer-nurse-anesthetist); takes more time (they can't do as many procedures/day); impacts their BOTTOM LINE negatively.

• Urologists also have to incur the time/expense of getting more anesthesia approved (pre-authorized) via Managed Care (insurance).   While the payers’ motivation “to pay the minimum” is an obstacle, this is no excuse--pain management is a legitimate; MEDICALLY NECESSARY category in case management.
  
While local/topical anesthetics can mediate some pain (multiple studies; confusing results), they are NOT comparable to safe MODERN pharmaceutical sedation/sleep techniques (e.g., used for colonoscopies).  We need to change the AUA’s paradigm for them by boycotting physicians that won't use these techniques.

Painless diagnostic alternatives to prostate gun-biopsy include color sonograms and magnetic resonance imaging (MRIs).  If there's a man in your life make sure he knows about them--my bad, I only learned about them after I was shot full of holes!  I'm no wimp, but NEVER again!

Hat's off to you women:  We men would NEVER survive delivering a baby!  Still, there's no legitimate reason for you to suffer the pain you have.

Blessin's,

Horheh
2 Tim 1:7

[MSKshelly]

Though obviously I can not comment directly on this procedure since I am a women, however I have had to go through some very unpleasant and painful in office procedures as well.  One of which my URO told me in advance multiple times would be very painful.  Knowing this I requested to be able to take pain medications before the procedure.

I ask him to use the lidocaine as well and had pain medication afterward as well.  I also
take a small gel pack ice pack that does not get hard to put on the area immediately
afterward. Several companies make very small ones that can fit without being seen visually.  I have had this procedure now multiple times..., and dread it for months
before I get desperate enough to go through it.  However even after commenting about
my ability to tolerate this procedure more then most, ,doctor did not seem to be incorporating the pain relief options to other patients who have had the procedure.  I know this because at one point I told him we needed to schedule the procedure again, (I go through about every 7mos to a year<) he offered to do it immediately.  Not having
prepared for it I waited and was hurting pretty bad by the time we did it.., his comment to me was that this was quick procedure and most people do not take anything before hand etc. so If I did not have a driver it would be worth doing it with out the meds. esp
since I seemed to tolerate it well.  The next time,. taking his advice I had no one to drive me so toughed it out other then lidocaine.  NEVER AGAIN, not only was it very
painful at the time but because of the level of pain during the procedure I could tell
that I was tensing up etc. making recovery weeks longer then the normal couple of days!

I would encourage you to discuss this with your doctor about the pain level and better options for controlling pain levels.  I really think they don't go through it so believe what they read!  They may not be able to get insurance companies etc. to cover the cost
of being put to sleep for this procedure, which could be one of the reasons they don't do so.  However even awake there are many ways to control pain. Again, talk to your
doctor and ask him.

You can make a difference by letting people know, talking to your doctor, and maybe writing to the American Urological Association.  You never know what impact you could have and in my opinion if I spare ONE patient of going through something so awful for no reason then I have made a difference.

I hope you heal quickly both physically and in your heart.

Shelly