Who had general anasthesia for their biopsy?

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GTOdave
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Date Joined Oct 2010
Total Posts : 175
   Posted 2/5/2011 10:15 AM (GMT -6)   
My younger brother is a fraud investigator for a major northeast medical insurance company. They have identified (he won't and can't tell me who) a NYC area urologist who claims all his biopsies are done under general anesthesia with an anesthesiologist present.

Obviously, the reimbursement rate is massively higher but I have never heard of anybody going nity-nite for this procedure.

Thoughts?
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci prostatectomy scheduled for March 4 at Yale. Lets hope attempt 2 at this goes better than my first try.

goodlife
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Date Joined May 2009
Total Posts : 2691
   Posted 2/5/2011 11:15 AM (GMT -6)   
There are guys on here who have had general. I think compiler did because of a scheduling quirk.

One guy on here referred to biopsies without a general as "barnyard medicine ".

For me it was no big deal. Wiped the goop off my butt, pulled my pants up, and went back to work.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

lifeguyd
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Date Joined Jul 2006
Total Posts : 677
   Posted 2/5/2011 11:30 AM (GMT -6)   
I am not sure what constitutes "general anesthesia".  For my biopsy I had an IV injection that someone described as "super valium".  I gently went to sleep and then woke up after the procedure.  This is the same thing that was used on me during the four colonoscopies that I have had.  They were all administered by a 'nurse' technician.
 
So maybe the doctor overspoke, as I consider general anesthesia more like what was used during my surgery. I remember that a doctor who identified himself as the head of anesthesiology did the work during surgery, so I assumed it was different. Same result though, went to sleep ...woke up...
 
 My brother had only a local anesthesia during his biopsy and complained of some discomfort.
 
 
PSA July 2006 4.7 , Nodule found
biopsy 10/06 very agressive gleason4+4=8 identified
DaVinci surgery, January 2007
Post Ob confirms, gleason 4+4=8 with no extension or invasion
no long term continence problems
post surgery PSA continues to be undetectable at 4 years
ED problems continue, using bimix
born 1941

James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 2/5/2011 11:54 AM (GMT -6)   
While I had mine under a local, I would have welcomed a little conscious sedation, like for colonoscopies, as mine was pretty painful on the last 8.

To answer the question, that option isn't one available at my doc's practice, which is the largest and most active in our area.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 01/11-.09
ED-total-Bimix 30cc

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/5/2011 11:56 AM (GMT -6)   
A few men here did have biopsies under GA, can't remember whom. I had 3 done, only 1 with a local and it hurt the most. The other 2 were minor events for me.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 2/5/2011 12:03 PM (GMT -6)   
My biopsy was done with IV sedation like is used with colonoscopies.  My urologist does that with all of his paitents.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

profman
Regular Member


Date Joined Jan 2010
Total Posts : 55
   Posted 2/5/2011 12:10 PM (GMT -6)   
I had two biopsies, both with just a local, and both were fairly mild in the pain department. Went back to work after both of them. I wasn't even given the option of conscious sedation.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3804
   Posted 2/5/2011 12:16 PM (GMT -6)   
i tried to get a general but my doctor wouldn't do it.  i asked him to refer me to another doctor and he agreed to IV sedation which really was pretty half-ass.  i found the biopsy to be much more tolerable than my mind had led me to believe.  something to take the edge off is all i really needed.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Post Edited (F8) : 2/5/2011 12:34:46 PM (GMT-7)


Ziggy9
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Date Joined Jul 2008
Total Posts : 981
   Posted 2/5/2011 12:47 PM (GMT -6)   
As someone who had has four biopsies only the 3D 45 pin saturation biopsy required IV sedation. The three other 12 core ones were no big deal. Not fun but I would never even consider asking to be sedated for. It sure isn't worth needing someone drive you home afterwards, IMHO.

DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 732
   Posted 2/5/2011 1:20 PM (GMT -6)   
My doc wrote in his biopsy report that the procedure was not well tolerated, should consider general anesthesia if procedure it repeated. However, that was the first and last time.

DJ
Diagnosis at 53. PSA 2007 about 2; 2008 4.3
Biopsy Sept 2008: 6 of 12 cores pos; Gleason 4+3 = 7
CT & Bone scan neg
Da Vinci at City of Hope Dec 8, 2008
Rad prostatectomy & lymph node dissection
Cath out on 7th day, in on 8th day, out again 14th day after neg cystogram
Path: pT2c; lymph nodes neg; margins involv; 41 grams,
PSA 1/08, 4/09,7/09, 10/09, 11/09,2/10 <0.01, 10/10 0.1

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 2/5/2011 1:27 PM (GMT -6)   
No sedation, no pain relief, no local anaesthetic, no general anaesthetic.
And very painful!!!!!

No way I ever want another one!

Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr CT
66Gy 28 Apr to 11 Jun 10
Tired + weird BMs
14 Sep 10 PSA <0.1
12 Jan 11 PSA <0.1
Erection OK

wigged-out
Regular Member


Date Joined Dec 2009
Total Posts : 130
   Posted 2/5/2011 1:40 PM (GMT -6)   
From what I understand, any kind of general anesthesia needs to be done at a hospital. This is in the event that something serious occurs during procedure with the anesthesia, there is a staff standing by. You want to be in a place where they can quick;y revive you in a worst case scenario.

Most practicing anesthesiologists work at a hospital, unless maybe some of them "freelance" or something.

My guess is that anyone who goes for a colonoscopy and has a sedative, they are close in proximity or in a hospital. This has been my experience. In fact, this would be my preference.

What helped me was the vallium, and also getting into a better frame of mind.

My first biopsy was awful, and I did not have a valium, because of the "unknown" factor: am I on my back? on my side? will I see anything? and son. All these little ???'s drove me nuts.

Second one with the added vallium and knowing what to expect went much better, though I'd still take five colonoscopies over one Prostate biopsy!

And as mentioned above, the added cost to the procedure I'd imagine goes way up.

W-O
Age: 55- good health. Exercise regularly.
DRE 11/08- no lumps, just enlarged prostate
PSA checked regularly, last 6.6/
Needle Biopsy 11/09- 12 samples. 11 OK. Right Lateral Mid- Adenocarcinoma Gleason score 3+3=6 9 involving 5% of specimen.
PSA risingto 8.0 thru 2010.
2nd biopsy- 2 positive cores, one a 3+3=6, 3% and the other a 3+4=7, 20%
Very last PSA- 12
DaVinci scheduled 2/14/2011

billye
Regular Member


Date Joined Nov 2009
Total Posts : 24
   Posted 2/5/2011 2:24 PM (GMT -6)   
if your ur wants to give you gas for the biopsy, i would question his skill. we

billye
Regular Member


Date Joined Nov 2009
Total Posts : 24
   Posted 2/5/2011 2:25 PM (GMT -6)   
if your ur wants to give you gas for the biopsy, i would question his skill. we

BillyMac
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Date Joined Feb 2008
Total Posts : 1858
   Posted 2/5/2011 4:53 PM (GMT -6)   
Under similar to a colonoscopy. Woke up bright as a button and ready to go.

Galileo
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Date Joined Nov 2008
Total Posts : 697
   Posted 2/5/2011 5:47 PM (GMT -6)   
I had one (my last) under general. Very easy. It was at my request, sort of. The doctor offered, seeing my face when told it was time for biopsy #3. And it was the biopsy that found the cancer. Maybe it helped his concentration not having me squirm and curse.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

axle
Regular Member


Date Joined Feb 2011
Total Posts : 35
   Posted 2/5/2011 6:34 PM (GMT -6)   
I had my biopsy a couple of months ago with a local anesthetic injection.  My biopsy was 12 cores and took less than 30 minutes.  There was some pain but it was not a big deal.  I can't relate at all to needing general anesthesia for this procedure.
Age 58; da Vinci prostatectomy on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive involving 40%.
Post-OP pathology: GS=3+4; tumor = 35%; R. seminal vesical invasion; Extraprostatic extension into the R. bladder neck; margins uninvolved

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 677
   Posted 2/5/2011 6:49 PM (GMT -6)   
 
I don't think that we have answered the question, What is General anesthesia?  Must it be done in a hospital by an MD to be full anesthesia?  The IV (versed?) procedure is usually done in an outpatient clinic by a nurse.
 
The original question seems to ask if a FULL doctor administered (anesthesiologist) procedure has taken place. So GTOdave, have your brother ask what  procedure is this doctor talking about?  Because in my opinion that should not be needed for a biopsy.   A nurse administered IV or local  is more typical.
 
 
sorry about the plastic surgery info, but it did tell the difference.  General anesthesia requires an MD and a breathing tube.

Post Edited (lifeguyd) : 2/5/2011 5:57:04 PM (GMT-7)


142
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Date Joined Jan 2010
Total Posts : 6949
   Posted 2/5/2011 7:16 PM (GMT -6)   
My biopsy was with a bit ot lydocaine. Nothing general or IV based.
As someone else said, wiped off the goo and went back to work.

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 2/5/2011 7:41 PM (GMT -6)   
Had my biopsy exactly one year ago this month. Was done in the local hospital O.R. with a bunch of people present doing their thing. I got the drug Propofol which was injected in the plastic line of saline solution. My research shows this to be a short-acting, intravenously administered hypnotic agent. Its uses include the induction and maintenance of general anesthesia. Had the same stuff for my Brachytherapy which I received just last May. Stuff was great with NO after effects and it totally put me "out" for the duration of the procedure plus. Maybe I'm just being a baby but I don't really want to be awake and hear all the maneuvers going on around me.

wigged-out
Regular Member


Date Joined Dec 2009
Total Posts : 130
   Posted 2/5/2011 8:08 PM (GMT -6)   
Again, when you're talkin' general, this should be done in a hospital setting. In addition with general anes. there is also a risk!

However, don't let your brain make you nuts. There are a ton of posts here here about dudes that have had the biopsy.

My biggest hang-up about he biop. was the unknown. This same crap happened the first time I was told I needed a crown (tooth cap) and freaked out for weeks because of the "unknown".

W-O
Age: 55- good health. Exercise regularly.
DRE 11/08- no lumps, just enlarged prostate
PSA checked regularly, last 6.6/
Needle Biopsy 11/09- 12 samples. 11 OK. Right Lateral Mid- Adenocarcinoma Gleason score 3+3=6 9 involving 5% of specimen.
PSA risingto 8.0 thru 2010.
2nd biopsy- 2 positive cores, one a 3+3=6, 3% and the other a 3+4=7, 20%
Very last PSA- 12
DaVinci scheduled 2/14/2011

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 2/5/2011 8:26 PM (GMT -6)   
Mine was NOT done with what I consider general anesthesia. Mine was IV sedation, ala a colonoscopy.
 
That's what I wanted but the Umich urologist talked me into the non-IV biopsy. But then it turned out I would have to wait 2 weeks or if I would be willing to  do IV sedation, they had an opening in the OR room in a few days. So, I jumped at it. I think there was an anesthesiologist giving me the IV sedation (maybe it was a nurse).
 
Mel

Paralleli
Regular Member


Date Joined Jul 2008
Total Posts : 123
   Posted 2/5/2011 10:02 PM (GMT -6)   
It really wasn't that big a deal. I just had a local (lydocaine?). Being snapped with a rubber band is the best description of the discomfort I've heard. I'm no tough guy, but as goodlife so eloquently put it, I too just "wiped the goop off my butt" and got on with life. I did bs the uro out of an extra antibiotic pill as I had my car loaded up for a 5 day pheasant trip and was leaving as soon as the procedure was done. Told him I didn't want the trip spoiled with an infection.

I think assuming the risks involved with general anesthesia for a mild discomfort is foolish.
IMRT 1/07 - Doing well.

DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 732
   Posted 2/6/2011 12:16 AM (GMT -6)   
Not related to anesthesia, but since we're talking biopsy--after it was done, I left, but discovered that I could not pee. Called them up and they said come on back. So I did, and they had me drink and hang around until I finally peed out a blood clot that had been clogging the works.
Diagnosis at 53. PSA 2007 about 2; 2008 4.3
Biopsy Sept 2008: 6 of 12 cores pos; Gleason 4+3 = 7
CT & Bone scan neg
Da Vinci at City of Hope Dec 8, 2008
Rad prostatectomy & lymph node dissection
Cath out on 7th day, in on 8th day, out again 14th day after neg cystogram
Path: pT2c; lymph nodes neg; margins involv; 41 grams,
PSA 1/08, 4/09,7/09, 10/09, 11/09,2/10 <0.01, 10/10 0.1

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 2/6/2011 12:45 AM (GMT -6)   
My husband had IV sedation, I think this was considered general aneasthesia, and his doctor said he preferred to do the biopsies this way. It was in a hospital where the urologost worked.

However the total cost of the procedure, including anaesthesia and hospital charges was less than Australian$2000 (US$2000) and then we got most of it back through insurance.

So it was painless, reletively inexpensive, and in my opinion, really worth it.

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01
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