PA vs Dr doing Biopsy

also, PSA is 6.1

I had 4 transrectal biopsies while I was on active surveillance (2012-2021); the urologist did each of those. (I have no idea about who does transperineal biopsies these days.)

When you indicate “… and remain the quarterback thru the Journey”, what does that mean?

@dribbles
Which Mayo are you going to?
Quite frankly never heard (but does not mean it is not done) a P.A. doing a biopsy? It is surgery procedure. Were you seeing a urologist? Most of the time urologist does the biopsy.

If you have biopsies transperineally there is a very low risk of infection versus transrectal at 2% risk (per Mayo Jacksonville urologist not my quote). Transrectal goes through the rectum.

Most every surgeon will tell you that the highest risk of surgeries is infection. Most hospitals will tell you they try to get you out of a hospital ASAP because of the increased infection rates while you are in there.

So if me, and I know I am not, would want the antibiotic.
Good luck on your biopsy!

When I had my biopsies 16 years ago, they were transrectal And they never offered antibiotics before doing them. My urologist is the one that did it, however. A fusion biopsy is a great way to do it, That way they can target the PIRADS 4 Tumor and get a few samples.

I’ve had multiple surgeries over the last few years and I’ve never had an infection as a result. Had a prostatectomy 16 years ago, had two knees and one hip replaced and a couple of other surgeries. They really seem to prepare ahead of time to prevent infection. Didn’t even have to take antibiotics after the surgeries.

I've had 2 "procedures" done relating to PCa. Biopsy and fiducial marker placement. Zero chance I would have let a PA do either procedure. Both were done rectally and both required oral antibiotic the morning of, and IM antibiotic injected just before the procedure. No infection from either.

@brianjarvis
probably wrong description but PA would be my main contact, not the decision maker of treatment, but PA implied Dr.s remain in background until the biopsy is done and then treatment decisions are made.
I also had a transrectal 2020 and would not look forward to another.

@jeffmarc
PA said they would target the lesion but also do full(12 core ) of the prostate. My thought is to skip the antibiotic if they'll let me.

@jc76
Rochester Mayo

I had my biopsy (TR) about 3 years ago. I was prescribed oral antibiotics to start taking a few days before and IM antibiotic for that and the maker placement.

@dribbles
You are going to get a lot of post about antibiotics. What one person gets or does should not suggest what you should do. Only your doctors have your complete medical and mental health history.

I don't see any post from those that did come down with infection from a transrectal. If you read their stories they definitely would not have transrectal again. Several past posters had serious time and recovery. I am not sure how many are out there got infections with transperineally. You can still get an infection if done transperineally but it is very low.

Urologist doing biopsies recommend antibiotics for a reason. The chance of infection is there and antibiotics are a preventive measure. For me doing something preventive is much more important that having to take massive antibiotics after a post procedure with an infection. But that is me and not trying to say do this or that.

My urologist (Mayo Jacksonville) gave me a 2% chance of infection if done transrectal. If done transperineally such a low number not given. However, with any surgery there is chance of infection and thus the antibiotics suggestion.

Most urologist and R/Os (doing markers and Space/Oar, biopsies) will do a smear to determine the specific type of antibiotic for you.

Your decision though. Talk to your medical doctors about your concerns.