prostate biopsy

[stebro]

I am a 63 year old male. I have had prostatitis problems for many years and take Proscar and Hytrin.
At my physical in 12/2007, my internist commented that my prostate felt a little large and suggested seeing a urologist for a general exam. My PSA in December was 0.9.  When I saw the urologist, he felt a nodule on my prostate and did an ultrasound which was inconclusive.  He said to get another PSA in three months and then we would decide if a biopsy was needed. I asked if a low PSA in three months would eliminate the need for a biopsy and he said it would not.  I asked why he wanted to wait for another PSA  if a biopsy would be necessary regardless of the results.  He then decided to schedule a biopsy, which is in two weeks.  I am not very excited (to say the least) about the biopsy or the possible implications of all this.  Do you think that waiting for another PSA would make sense or do you recommend proceeding with the biopsy?  Is there any risk to a biopsy?
Thanks.

[Enoch Choi, MD]

The valium will help relax you stebro.   The wine/food the night before isn't a problem.  Making sure you stay well hydrated if you drink too much wine, is very important, by drinking twice the water in volume that you drink of wine.

Prostate biopsy is so fast that i've never heard of folks being under conscious sedation for it.

[stebro]

I just spoke to the doctor who is performing the  biopsy.  He is prescribing Valium to take the morning of the procedure. One question I forgot to ask him: We are  attending  a big annual food and wine event the night before the biopsy.  Is there a problem with either consuming lots of food or drinking wine when I will be taking Valium and having the procedure the following morning?

[Teamdeboy]

Why can't they sedate you when you have a prostate biopsy? Is there a rule of thumb? I know they sedate you if you have a colonoscopy, whats the difference? Sounds very painfull and if you want to be sedated, looks like they would! HHMMMM Thanks, I find your advice very helpfull!

[Enoch Choi, MD]

my dad had it done.   my father in law had it done.  it's better than dying of prostate cancer.  not ever done under conscious sedation (iv sedatives).  oral sedatives are a good option.

[stebro]

I've been reading about prostate biopsies online and they sound pretty awful. My doctor uses injected lidocaine before the biopsy but they still sound painful and awful.  Are prostate biopsies ever done with iv sedatives (demerol, versed, etc.) like colonoscopies?  If not, would you recommend asking for an oral sedative?  The procedure is ten days away and I'm already getting pretty anxious!

[Enoch Choi, MD]

if in 3 months the PSA results wouldn't change his recommendation to be biopsied, i'd say do it in 2 weeks when he recommended to have it.

there is risk: bleeding (controllable), infection (treatable with antibiotics).  the risk is often worth the helpful information from biopsy