Hello,

I went ahead and researched the two methods. The literature seems to suggest that freehand will give similar outcomes to the stepped method.
if it was me, and btw I have a bouncing PSA that runs high, I would lean towards the freehand.

I have had over the last ten years, two trus  biopsies prior to TPC/IPAA surgery and can’t and won’t have future similar traditional biopsies.

please keep us up to date as this is a very important topic for some of us.

btw, does your care team have a preference/recommendation on this?

thank you,

eric

Hello Eric and thank you so much for your thoughts.   My options are with two different physicians at two different hospitals.  One in CT, the other in MA.  Both physicians are non-committal.  The location that does the stepper technique are not authorized to do the free hand.  The doctor that would use the stepper technique has done this on men with a J-Pouch, he just hasn't done biopsy fusions on one with a J-Pouch.  The free hand physician has done about 6.

The upside is that both procedures take about 20 minutes unless you've heard otherwise.  I am leaning towards the free hand technique because of it being less invasive as far as the skin punctures are concerned.   The local numbing is what's challenging for me.  I'm thinking the worse too when it comes to the pain.  Although he has offered me a valium an hour before the procedure and told me he would abort if needed.  I'll be checking with my Pouch surgeon this week for his input on the two techniques.

I'm not sure what you mean by TPC and IPAA are.

Thanks again...

Joe

TPC/IPAA is shorthand for total procto colectomy/ileo pouch anal anastomosis.

I agree with you, the less invasive the better, as long as you can achieve accurate results.

i assume you are on active surveillance and are following up as per your AS protocol.

I have lots more questions, so if you want me to private message you I will.