Transperineal Biopsy and ED

KenTO

I'm a 55 year old male scheduled for a TPB next week for MRI findings of two PIRADS 4 lesions 7 mm each on the right side, but I also have a trip scheduled the week after with a new girlfriend. Anyone have any experiences with side effects after, specifically erectile dysfunction and how long it lasts? Thanks!

centralPA

No ED following biopsy, but be prepared to freak out when you see what comes out during sex. Your prostate will have been shanked repeatedly, and lots of blood will accompany the usual product. For a couple of weeks following.

KenTO

Ok thanks, how much blood, a lot or trace

centralPA

https://csn.cancer.org/discussion/comment/1721791#Comment_1721791

Enough to freak out a girlfriend, I am sure

Wheel

Typically not blood what you think of like coming from a cut that is bleeding. This blood gets mixed in with your thick semen and the semen is what is very discolored, it is very rusty looking. Really don’t think your girlfriend would enjoy seeing it. Use a condom temporarily and it can stay inside the condom, get it off quickly and flush it before she really gets to notice it.

centralPA

Or let her know there is a surprise in store. Or better yet, don't. :)

swl1956

Sorry that I'm finding some humor in this thread. 😀 When at 67, I had just starting meeting up with a woman I had been drooling over for years that lived local. Just my luck, bu at the same time I also just had a biopsy and cancer was diagnosed. Not an easy thing to both date and deal with prostate cancer. I just came right out and told her. I decided to stop pursuing her. At this juncture after a Focal ablation I have no ejaculate at all. I'm also now on ADT which completely douses a mans sex drive. I could be in a room full of gorgeous naked women and couldn't care less about jumping them. As weird as this sounds, it's almost a blessing. Lols! Anyhow, I've had three biopsies. One transrectal and two transperineal. No erectile dysfunction in any. In both my transperineals very little blood in semen. Had a lot of blood with the transrectal. I'm sure it varies in different men and likely the skill of the surgeon has an impact as well.

My opinion is to be honest with her. If she dumps you over that, she's not worth your time anyhow. Anyways, In the big scheme of things not the toughest decision life might through at you. I wish you good luck. Please keep us posted.

KenTO

Well, my girlfriend is 23 years old and a perfect 10, we only started dating 2 months ago, the fates are certainly messsing with me.

swl1956

https://csn.cancer.org/discussion/comment/1721801#Comment_1721801

Yeah! I can see your dilemma. Fate sucks sometimes. Geez! 32 years younger woman. Don't worry about Prostate cancer, you'll likely die of a heart attack first. Lols! A very wise man told me "You can only play the cards we are dealt."

KenTO

Hearts good, last time we were together four orgasms in one night (thanks Cialis), guess those days are gone, thanks for all the advice

centralPA

If you have a prostatectomy (or a holep) you’ll be able to fake as many as you want. 😉

KenTO

If my biopsy is positive I'm considering nanoknife, anyone have experience with that

swl1956

https://csn.cancer.org/discussion/comment/1721816#Comment_1721816

Yeah! I'm sort of an expert on Nanoknife. That is "expert" being defined as: ex is a has been and spert is a drip under pressure. Lols! I took a shot at Nanoknife for my primary treatment because I did not like either RP or RT side effects. Some on here will frown at procedures not deemed Standard Of Care, but I figured with a much less side effect profile Nanoknife was worth a shot and I would still be able to have either of the radical procedures afterwards if needed. Anyhow, even though Irreversible Electroporation aka IRE Nanoknife did not irradicate the cancer in my case, the ablation area of my tumor was treated successfully. I'm still a believer that Focal Therapies are a good choice for some men. The data is very promising for those that qualify. I did qualify, but there was micro metastasis that didn't show up on my earlier PSMA PET scan which reared its ugly head in my lymph nodes six months after the procedure. Likely would have happened no matter which methodology I chose. To qualify it depends on location of tumor / tumors and other factors such as Gleason score and no evidence of metastasis. PSMA PET scan is a must in my opinion before any therapies. Once you get your biopsy results you'll have more info on what your next steps might be. Keep in mind the skill and experience of the doctors you see is paramount no matter which decision you go with. I strongly suggest you confer with a cancer center of excellence. I'm sure you're stressing about all this now, but hopefully you'll end up with a low Gleason score which will take a little pressure off. Low gleason scored cancer is very slow progressing which will give lots of time to make decisions. The book "Guide to surviving prostate cancer" by Patrick Walsh is a good resource. I also especially like YouTube videos that Dr. Mark Scholz puts out. He is the founder of Prostate Cancer Research Institute. You'll find that the information about Pca is daunting. https://pcri.org/ Hang in there! and good luck with your 23 year old girlfriend. I'm not jealous at all! 😉 Lols!

KenTO

Thank you for the valuable information and resources. I'm actually not stressed surprisingly, went on a few therapeutic mushroom journeys that conquered my anxiety and fear of death, death is inevitable, trying to live my life to the fullest and not stress over things I cannot control. Quality of life is more important to me than quantity, but you are right, I do need to wait for the Gleason score.

KenTO

Seeing the 23 year old tonight, popping a Cialis now, trying to get in as much sex as possible before the biopsy lol.

KenTO

I was supposed to get my biopsy Thursday, woke up today with, fever, myalgias, fatigue, sore throat, I'm Covid positive, let the Clinic know, , now biopsy rescheduled to end of May, is that too late, any monitoring I should do in he meantime? Thanks

centralPA

Nothing to be done other than let them know if they have an opening, to give you a call.

PCa is usually slow moving, biggest risk is your anxiety. Just keep taking advantage of the delay with your girlfriend.

Wheel

I would try to get yourself on a cancellation list. The Doctor doing the biopsies must be very busy doing them if his next scheduled opening is not until the end of May.

KenTO

ok, should I monitor PSA, free PSA ratio just in case, and Covid is really hitting me, high fever, body aches, temp not coming down and I've been vaccinated 4x and had it twice, but last time over 2 years ago, thought it was supposed to be a cold

swl1956

If your girlfriend gets lonely during your illness, you can give her my number. 😉 Lols!

You certainly are having a run of bad luck lately. Hope that turns around. A few weeks wait likely won't make any difference except for the worry factor that centralPA pointed out.

KenTO

ok, thanks for the advice