So I finally got to see the urologist, Dr. Singal, at his clinic this afternoon and the visit went more or less the way I had anticipated. His performed a DRE for his own edification, as he put it: “I’m sure you been poked there before but the only finger that counts is mine.” Now that I read that it seems creepier than it did at the time. Basically he wanted to see for himself if the other doctor was correct. To be honest I don’t know what the big deal is about DREs.
I had posted to an internet forum about going to see the urologist and wanting to know what to ask. I got a lot of responses and from that formulated a list of questions,
What about the PCA-3 test? He felt that it’s use was limited since I would need the biopsy anyway, and that it is more useful for men who have to undergo repeated biopsies after negative results. He also mentioned that as a bio-marker it wasn’t the best.
What about MRI guided biopsies? They are not common yet, so I could do one in the U.S. if I really wanted to but that tumors and lesions are not always visible in MRIs and that the “blind biopsy” isn’t exactly blind that it is guided and he can see what he’s doing.
Who would do the biopsy? He would. That was important to me since I didn’t want to get schluffed off to some resident or nurse.
What about local anesthetic? This was one of my bigger questions. I have read some accounts which make the biopsy sound worse than paper-cut between your toes (you cringed just a little didn’t you?) and other accounts which were totally dismissive. He said that there was a concern regarding injecting something into the prostate, which at the time seemed to make sense but now I’m having second thoughts since the biopsy needle is pushing something into the prostate. However a quick internet search confirmed this was actually true. Poor Dr. Singal is going to have his hands full with me.
He mentioned that most men complain about the ultrasound wand going in. I cut him short and informed him I was gay and that wasn’t going to be an issue that I was much more concerned about the needle. He then mentioned he had done over 3,000 biopsies to which I pointedly asked how many he himself had received? In the end he gave me a prescription for a sedative to take the edge off and calm my nerves. I figure I can also take a Tylenol before hand as well. I did the same thing when I got some of my later tattoos and it seemed to help.
So I said we should go ahead with the biopsy, which is scheduled for next Tuesday. As I was leaving he said something to the effect of, “Trust me, I’m going to take care of you.” Which I thought was probably the perfect thing to say.