Prostate Template Biopsy - any problems after the procedure?
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My urologist has seen it necessary to give me 3 template biopsies, 2 of which I was told later by another urologist were completely unnecessary. Of course a urologist along with his anesthetist & the hospital ect get paid for these ops. Sometimes patients are over treated.
Has anybody had any long term effects from a template biopsy like less ejaculate & semen. When I spoke to the original urologist about this, he was unable to acknowledge that this might be the case, that the prostate had been damaged by the biopsy. Of course he could be right, but I'd like to know if anyone else has had a similar problem/outcome?
0 likes, 10 replies
ian57943 Peter02
Posted
Oh I can relate to that. I am still, 5 weeks later, still suffering from the after effects of a template biopsy. I have had AUR and am stuck on a catheter so can't help with those other queries, sorry. I have not read of any of those issues you mention from my searches.
david7015 Peter02
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j12080 Peter02
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geoff90305 j12080
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Spot on j. The urologist industry not really interested in mpMRI, as it helps with the question to biopsy or not.
Due to a rising PSA, and not being able to get into a urologist for a few months, I arranged for a mpMRI(there is no government/insurance subsidy) and it came back saying no meaningful PCa found. When I eventually saw the uro, he said," ummm, looks like nothing there, must have been the UTI and now you have prostatitus". He still asked me if I wanted a biopsy...just in case. Nah!
geoff90305 Peter02
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So, why did you need three biopsies? Did you have a previous mpMRI to be able to target the lesion(s)? Was the first biopsy negative, and the uro decided you had PCa somewhere in your prostate and wanted to find it, regardless of the outcomes for you? Did you still have a rising PSA? How many months apart were the three biopsies?
Peter02 geoff90305
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Template biopsies, 2011, 2013, 2015. These were follow ups on MRI's where there was the possibility of cancer. Each one found only 1 core with at most 1mm of cancer. The first template biopsy was in fact made after a transrectal biopsy (I had BPH) when the cancer was first discovered. Gleason scores 6/7. My PSA is between 3.5/4.5, having moved up v slight in the last 6 yrs but I'm 68 yrs old. I did need antibiotics on one occasion.
Just to point out, a transrectal biopsy does take about 10 mins 'in office' where as a template biopsy (aprox 24 mapped cores) is done 'in theatre' under general anesthetic, so there is a substantial difference in cost.
There are now guided ultra sound & MRI biopsies, which, from what I gather, can target the biopsy, following an MRI scan, to the exact point you need to examine. This is what I will demand in the future if it's required.
geoff90305 Peter02
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OK, when you had the mpMRI, did they give you a PIRAD score? Also, the radiologist would give you a report stating the dodgy lesion(s) size, where located, and if they think it has invaded the seminal vessels and further. Your biopsy then would tell you how invasive it is likely to be. So, was your Gleason a 3+3, 3+4 or 4+3? usually, 6 or less, considered non invasive and probably ok for active surveillance.
I had a bad UTI last April and my PSA raised from 14 year average of 2.4 to 13 in 3-4 months. After several weeks of cipro, the pains etc subsided, but uro agrees, some infections in the prostate can hang about a bit and take a long time to clear up. My brother's prostatitus from a UTI took over 2.5 years for his PSA to return to normal-ish. I look like being the same.
So, after you have had three biopsies on the prostate, it is no wonder it is a little sad. My uro mostly does MRI guided biopsies and transperineal with the MRI template guided biopsies. And agree, no use with a blind biopsy, it needs to be guided, otherwise you miss the "spot".
Peter02 geoff90305
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Did not get a PIRAD score I don't think? What I have is not v invasive (at the moment), lesions siizes no more that 1mm & not near the seminal vessels. Last biopsy Gleeson 3 + 4 & it was decided to stay on Active Survellance. MRI guided biopsies from now on if required! PSA goes from 3.5 to 4.6 but I'm now 68.
j12080 Peter02
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Peter, in your situation with a diagnosed PCa I would think you would consider strongly having Focal Laser Ablation. This is what it is for in the prostate. Using it for BPH as I did is an after product of the results found with FLA for PCa. This is what Dr. Karamanian MD is trained Interventional Radiologist specializing in Prostate and has done many PCa removal procedures with FLA. It is day procedrue you walk out and go back to life without the PCa. It is very precise, up to a mm of accuratcy and therefore no sexual side effects which go along with other procedures.
With a focal needle MRI guided biopsy, and if the Gleason is less than 7, you could be cancer free and not have side effects. I assume you have BPH also and it would be very possible to have a "two for one" procedure. Just something to consider as he does it all and could do it in one procedure. Just something to consider. If you are interested he can and does extensive consultations for no charge and you could call him. Does not hurt to research.
Good Luck John
j12080 Peter02
Posted