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Anesthesia

Versed For Prostate Biopsy?

10/14/2009

Question:

I`ve had three rectal prostate biopsies and found them to be miserable painful experiences. I asked my urologist why he didn`t give me something such as Versed and he pretty much blew me off saying that it wasn`t necessary. (Easy for him to say!)

Is he following normal procedure or might there be other urologists that would sedate me in the future?

Answer:

There are urologists who do prostate biopsies under general anesthesia. There are also those who perform these without any sedation at all. I am not aware of any data about how many of these increasingly common procedures are done with general anesthesia, with sedation, or with nothing at all. If I find any such data I will update this answer.

Sedation, in North America, is usually the responsibility of an anesthesia professional - an anesthesiologist (doctor) or sometimes an anesthetist (nurse) or anesthesia assistant (under supervision of an anesthesiologist). In many settings however it is the urologist who has the discretion of obtaining the services of the anesthesia provider. You may have the discretion of choosing a different urologist if your current urologist is unable or unwilling to provide your with a more comfortable experience than you've had so far. This may involve the use of Versed (midazolam) but would also typically include an opiate like fentanyl or in fact a full though brief general anesthetic with various other agents.

The benefit of really good sedation or anesthesia is not only a comfortable patient but a comfortable surgeon who can take his time to get adequate prostate tissue samples without the stress of a wriggling, anxious and sometimes vocally expressive patient.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University