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Shocked!!!
My urologist prescribed a transrectal prostate biopsy, so I went to the appropriate doctor at the main hospital in the country.
To break the ice, I said to him that I hoped he had plenty of lidocaine, which is the normal pain-prophylaxis as the procedure consists of sticking 10-20 (usually 12) needles, 1.6 mm diameter, through the rectal wall into the prostate gland which is richly doted with nerve endings. Local anaesthesia has thus been standard practice for 25 years. He replied that he never gave local anaesthesia. I asked why not? He said that it was not normal practice when he started taking biopsy samples and he saw no reason why he should change now!!!
He also said that, in view of my age, he would just take six samples. Sextant biopsies were abandoned over 20 years ago, because it needed a minimum of 10 to 12 to be reasonable sure of hitting a tumour.
Normally, I would have expected a mild sedative injection, before starting. Not given!
I had two microenemas earlier and had started on an antibiotic course the previous day, as preparation. I expected the biopsy site to be thoroughly prepped with an antiseptic cleaning solution to remove any residual faecal contamination. No way was this done.
I also expected to have the procedure done in a reasonably sterile environment. I expected too much. An examination couch in his consulting room.
I lay down, in my street clothes (including shoes) on the couch in a foetal position and was sodomised with a gel coated ultrasound probe. I won't say it was painful but it was decidedly uncomfortable, as he manipulated it into different positions.
Now for the good news. He renounced on performing the biopsy as the rectum wall was thickened and this may result in excessive haemorrhaging, exacerbated by the radiation therapy I had in 1995. He had no means at hand to cope with heavy bleeding. Did he never anticipate a patient may bleed when brutalised that ha had no laser cauterisation equipment? Boy! Was I relieved! He referred me back to my urologist.
Final note: as I was leaving, he said I should restart my daily mini-aspirin dose and to stop the antibiotics. Now, I was under the impression that drug-resistant bacteria were a result of mutations due to curtailed antibiotic courses. I checked with both types and they both said that a course should be 5-8 days and not to interrupt it. I grant you that, in this case, the raison d'être for them was no longer there (ie no invasion of the prostate) but, IMHO, it would be folly to stop taking them prematurely, so I'm taking them for 5 days, despite what this dinosaur of a doctor said.
To say I'm shocked by this mid-20th century experience is an understatement.
To break the ice, I said to him that I hoped he had plenty of lidocaine, which is the normal pain-prophylaxis as the procedure consists of sticking 10-20 (usually 12) needles, 1.6 mm diameter, through the rectal wall into the prostate gland which is richly doted with nerve endings. Local anaesthesia has thus been standard practice for 25 years. He replied that he never gave local anaesthesia. I asked why not? He said that it was not normal practice when he started taking biopsy samples and he saw no reason why he should change now!!!
He also said that, in view of my age, he would just take six samples. Sextant biopsies were abandoned over 20 years ago, because it needed a minimum of 10 to 12 to be reasonable sure of hitting a tumour.
Normally, I would have expected a mild sedative injection, before starting. Not given!
I had two microenemas earlier and had started on an antibiotic course the previous day, as preparation. I expected the biopsy site to be thoroughly prepped with an antiseptic cleaning solution to remove any residual faecal contamination. No way was this done.
I also expected to have the procedure done in a reasonably sterile environment. I expected too much. An examination couch in his consulting room.
I lay down, in my street clothes (including shoes) on the couch in a foetal position and was sodomised with a gel coated ultrasound probe. I won't say it was painful but it was decidedly uncomfortable, as he manipulated it into different positions.
Now for the good news. He renounced on performing the biopsy as the rectum wall was thickened and this may result in excessive haemorrhaging, exacerbated by the radiation therapy I had in 1995. He had no means at hand to cope with heavy bleeding. Did he never anticipate a patient may bleed when brutalised that ha had no laser cauterisation equipment? Boy! Was I relieved! He referred me back to my urologist.
Final note: as I was leaving, he said I should restart my daily mini-aspirin dose and to stop the antibiotics. Now, I was under the impression that drug-resistant bacteria were a result of mutations due to curtailed antibiotic courses. I checked with both types and they both said that a course should be 5-8 days and not to interrupt it. I grant you that, in this case, the raison d'être for them was no longer there (ie no invasion of the prostate) but, IMHO, it would be folly to stop taking them prematurely, so I'm taking them for 5 days, despite what this dinosaur of a doctor said.
To say I'm shocked by this mid-20th century experience is an understatement.
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