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Biopsy Decision
I’m 59 and in good health.
After a PSA spike from 3.1 to 4.8 ( since bounced around to 4.4) I had an MRI. Currently on Tamulosin for BPH.
MRI showed a 1.2 cm lesion but no evidence of any spread and a PIRad 4 score. Scarring was noted due to prostatis in another area of the prostate. PSAD was .08 which I understand is pretty low.
I’m a Grok/Chat GPT addict when it comes to medical issues. When I plugged in my MRI both noted DCE was not noted as positive and therefore Rule 2,1 of scoring dictates this a PIRad 3.
Saw the urologist yesterday …. Fellowship trained urologist oncologist. He immensity started down the biopsy road. When I questioned the MRI ( showed him the report) he said let’s have another urologist review but even if a PIRad 3 I would probably want to biopsy anyway.
I’m awaiting the newly reviewed MRI results ( and going to send a copy to Mayo for another opinion as well).
Everything I’ve read ( again Chat/Grok) states that the recommendation for PiRad 3 with low PSAd is wait ( perhaps try a round of anibiotics), test PSA every 3 to 6 months and the repeat MRI in 12 months.
I’m not one to question fellowship trained urologists but if this is indeed a PiRad 3 with low PSAd (and everything else on the MRI appeared ok) I’m struggling on what to do/who to believe.
Grateful for any thoughts….
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@jc76
It was transrectal, under general anesthesia. I took antibiotics before and after the procedure.
I know tranpernial reduces infection risk to zero, but it is usually more painful and is even more reason to insist upon general anesthesia.
My understanding of biopsy induced odynorgasmia is that it is usually caused by minor (hopefully temporary) nerve injury.
Typically, this pain is self-limited and resolves as the affected tissue and nerves heal over time.
In my case, I believe some amount of nerve damage occurred and the timeframe for full and complete recovery, in such cases, may take up to 6 to 12 months.
Nerves affected by trauma or irritation during the biopsy typically undergo a slow healing and regeneration process.
Again, I do not believe my post biopsy symptoms are normative; however, they do occur in a small, but not insignificant number of men.
@jc76
Just curious, but did your urologist mention that odynorgasmia was a possible side effect of biopsy prior to having it performed in your case?
I’ve never heard of anyone indicating they were informed that odynorgasmia was a possible side effect (even though unlikely) of biopsy.