Anyone Have A Negative Prostate Biopsy Due to BPH with a Lesion?

I've had several biopsies and a couple color doplar scans. My PSA was 21 when I had a HoLEP January 2025. They sent out to the lab what they removed and there was no cancer. I had BPH for 20 years, until I had total shut down. First biopsy was 6 cores, second was 12 and last one was only 2 cores.

I've had a couple of biopsies, a couple of MRI's and a CT Scan. Thanks to God: no lesions, no cancer. Still with BPH. Pray to God is nothing and always walk by His side.

I had 2 transperineal biopsies at one provider , 1 year apart with a diagnosis of Gleason 3+3 Grade 1 prostate cancer with only 1 core showing cancer. Placed on Active Surveillance. I went to a major medical center and underwent a third biopsy, but this time I had a transrectal biopsy. It came back negative…no cancer noted. I was excited that I maybe did not have cancer after all. When I consulted my Primary Care Doc he says No….. you still have cancer, they just didn’t find it with the transrectal biopsy. His opinion was that maybe the lesion was really small. Well it was noted as being 4mm in size. Primary Care Doc says anything smaller than 1 centimeter (10mm) is difficult to see on MRI. Go figure!

Yes, I've had BPH forever and my PSA got up to 7. MRI showed a Pirads 5 lesion, high probability of cancer. Had a transperineal guided biopsy with 18 cores and NO CANCER. One year later another MRI showed the lesion had resolved on its own. 4 years later, this year I had a PAE and now I'm off my BPH meds, getting up once per night, and hardly any BPH symtoms.

@av8r6
Wow…A true success story. Thanks for sharing your experience. I know every man hopes to have your results after a biopsy and MRI. I’m very happy for you.

I have not ever heard of a lesion, especially a PIRADS 5 disappearing on its own. That is great !
How was the recovery from the PAE procedure ?

Thanks Again for sharing.

@indyguy Thanks, I'm definitely lucky. From what I understand, MRI diagnosis of prostate lesions has a long way to go.

My recovery from the PAE was worse than I thought it would be. I flew to Raleigh for the procedure. I booked a hotel for 3 days and it was barely long enough. It hit me hard. Felt like my pelvis was being attacked. Extreme diarrhea and really painful urination. Gradually better every day and then, poof after about 2 weeks, urination pain went away, and I felt what I would describe as a calmness in my pelvis. It was the day before my birthday, and I immediately stopped the Alfuzosin. Been great ever since, 5 months, and just waiting for my eyes to recover from 2 years on the Alpha blocker.

I have bph. I’ve had elevated psa levels as high as 27, and a pirads 4 lesion that ended up being Gleason 3+3. However, in a second follow up biopsy 18 months later no cancer was found. I’m getting ready to do another MRI and possible biopsy 3.5 years from first detection. I’m hoping my elevate psa is due to bph as well. So yes, there’s a chance elevated psa’s are due to bph. My doctor has told me they’ve got a few patients whose psa levels bounce all around but don’t test positive for cancer. Of course the biopsies could just be missing the cancer as well.

Hi Indyguy! I think I have a history that you might find interesting and a bit encouraging. I will try to keep this brief enough so as to not bore you or anyone else reading. My journey related to prostate issue -- let me say straight away, although all indicators pointed toward cancer, the biopsy showed that I did not have any sign of cancer, not even close! Early, my urologist said, "elevated PSA does not mean you have cancer, and clear or normal digital exam does not mean you do not have cancer." He was right. My PSA during a routine annual exam showed more than a doubling in value in a year, from 2.0 to 4.3. I was a bit alarmed. My father died from prostate cancer at 65 -- my age exactly. I met my new urologist with whom I developed a great professional relationship with trust and plenty of humor straight away. His DRE was "negative" -- normal sized prostate, no nodules or atypical consistency. Because of the PSA change and father's history, we scheduled the MRI. Radiologist reported a suspicious mass, though small, he could not decide between PIRADS 3 or 4. My urologist said he thought 3. Luckily, borders intact, no other unusual findings in my pelvic area including bones and related nearby organs. A bit unnerving, but also relief. If the spot is cancer, it is small, early and contained. Doc said it would be easy to address, maybe even monitor (watch and see). On to the biopsy which was fascinating to me. I wish I could see what he was doing collecting 16 core samples. Instead, Doc narrated everything he was doing, play by play. We shook hands and he reiterated that the suspicious spot may be nothing -- asked if my prostate was enlarged? The answer was no, my prostate appeared very normal and healthy. The biopsy results confirmed that assessment. After four months of concern and even worry, including changing vacation plans to visit family instead of going overseas (my preference), the pathologist reported that there was NO indication of cancer or abnormality in any of the 16 core samples! So, it does happen. Anomaly? I have no idea. I am genuinely relieved. I hope your journey is similar to mine. Either way, I truly wish you well and I hope your care team is as fantastic as mine.

I have had BPH with elevated PSA for over ten years. I've had a prostate biopsy, MRI, CT Scan, experimental blood tests, etc. all showing negative signs of cancer. My most recent MRI also showed a PIRADS 3 lesion. I've also been on Dutasteride (Avodart) for almost a year now and my PSA has significantly dropped (to normal levels). My doctor feels confident this is a very good sign.

Thanks for the replies.
I did receive good news on my prostate biopsy and everything was benign.

I have been worried for years about my PSA and prostate size. I had been putting off doing any further testing. I had a PIRADS 3 lesion and that’s why I did the biopsy.

I am taking the win for now and very thankful.
Thanks Again !