Prostate Biopsy

thank you

i did ride a staionery bike and ejaculated

Based on that, I would ask your doctor to retake the test. Take it easy a few days before the test, and no bike riding, no ejactulating. If it's high again, then do a biopsy or MRI.

seems like the recommendation is mri before biopsy? why is that

thanks

What is the prostate size? Your doctor probably wants to be sure no cancer before the Rezum. You may repeat the PSA without sexual activity for a couple of weeks before the test to see whether the PSA level decrease or not.

You would want to do MRI before biopsy because MRI is less invasive. Biopsy can sometimes cause problems, like infection. If a lesion is seen in the MRI a targeted biopsy can be done using one needle instead of the random 12 or 16. The single needle targeted biopsy is more accurate than the random multi needle biopsy which can miss a lesion.

You should repeat the PSA test without disturbance to the prostate.

If you do the MRI it should be a Muti Parametric 3 Tesla MRI. I think Multi Parametric might just mean with a contrast agent. You should get someone to read the MRI who is an expert at reading prostate MRIs for cancer, instead of a generalist who interprets all types of MRIs.

retested psa 3.7 down from 6.9 how is that possible?

There is a lot of debate regarding the value of the PSA test. In your case, you get a high result and you get worried. Then you get retested, it goes back down. You could have a PSA of 2 and have cancer, and someone with a PSA of 6 doesn't. A large bowel movement can make your PSA go up to a range your doctor wants to do a biopsy that then puts you in the hospital. If your doctor says you have a tiny prostate and your PSA is 2, you might have a cause to worry, but maybe it's just because you road your bike the day before. PSA on it's own without a measure of your prostate size is somewhat useless IMO.

thank you for the feedback. i do have BPH

Any activity that stimulates the prostate can skew the PSA results in the wrong direction. That can include (and not limited to) ejaculation, bike riding, strenuous bowel movement, and even the dreaded but useful digital rectal exam (DRE). A few days separating those activities and the blood work makes the PSA values a lot more accurate. And if you visit your doc for a DRE, make sure he does that AFTER drawing blood in the office, not before. Or just wait a few days before doing the blood work.

thanks for the feedback.

Does your uro want to perform the prostate biopsy?

yes had on 2/1

Most likely the biopsy result is negative because your PSA level had already decreased from 6.9 to 3.7 before the biopsy. Otherwise, it is surprised! Report back after you get the results.

thanks i will let you know

not sure of size but its large