Possible Prostate Cancer: Are there side effects of MRI fusion biopsy?

Posted by kpg7121 @kpg7121, Feb 12 2:26pm

This past November my primary care Dr discover a lump in my prostate during a digital exam. He referred me to a urologist who scheduled an MRI of my prostate which showed a Pi-Rads 3 lesion. In March I am scheduled for an MRI fusion biopsy. I am 69 years old, my PSA is 4 which jumped from 3 within a year. I am not experiencing any real symptoms except having to get up occasionely in the middle of the night to urinate & occasionely feel as though my bladder is not totally empty. I am not in any pain or discomfert. I am in good health otherwise & active. The urologist also diagnosed me with BPH. Are there any side effects of this fusion biopsy that I should be aware of as the urologist was not very forthcoming in explaining this procedure. Any advice would be very much appreciated.

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jeff1963 | @jeff1963 | Feb 12 2:58pm

Prostate biopsies are common, people don't have issues usually. Both trans perineal and trans rectal have a small chance of infection, but trans rectal has a slightly higher chance. Trans perineal has better access to all areas of prostate.

I had one of each, neither was a problem for me. A little uncomfortable, but not too bad for me.

Afterwards, there will be blood in urine for a while. Also, blood in semen...with trans perineal this lasted for a long time for me, longer than most people say.

You do want a biopsy, and you do want a fusion biopsy. It will give you good information about next steps.

Only advice (and don't mean to be too gross here), but if you have trans perineal, whatever you do, when you leave do not look back at the operating station...it will be a bloody mess, I still cannot get that image out of my mind.

jayhall | @jayhall | Feb 12 3:30pm

I've had two Transrectal Biopsies and the main side effect I had was the Antibiotics gave me colitis. I went to my PCP and they gave me some RX's and I was fine after that. If you are prone to colitis from Antibiotics you might go to your PCP and get some RX's that control GI issues. They will give you a sheet of instructions and you should follow them. The blood in the semen is the worst and mine each time lasted 8-9 weeks. The instructions they give you will say "blood in the semen" but it's more likely your semen will look like blood.

As suggested do not look at the amount of blood on the station as you leave, just don't. Also wear clothes you care nothing about and be prepared to throw your underwear away once you get home. You will walk funny the rest of the day of your biopsy. Be careful sitting or standing. The biopsy itself wasn't horribly painful but the shot of Antibiotic can hurt. You might also ask your PCP for some mild pain killers.

You will want to stay close to home for a couple of days after your biopsy because you will be asked to drink liquids to stay hydrated.

You will also want to clean your toilet/bathroom before and after your biopsy. If you have older towels use then to dry off after your showers etc.

kpg7121 | @kpg7121 | Feb 12 4:29pm

Thanks for the replies. What about driving after the procedure? The biopsy site is 50 miles away. I probably shouldn't?

jeff Marchi | @jeffmarc | Feb 12 4:50pm

I had three biopsies and drove myself each time. Never was an issue. It is true some people have had issues.

As others have mentioned, you really want to get a transperennial biopsy if possible. They can reach more of the prostate with it, and there is a smaller chance of infection.

PIRADS 3 is iffy and frequently means nothing, Occasionally it does point to cancer. The fact that you have BPH would explain your increase in PSA. Frequently cancer is found in other spots of the prostate, where there were no lesions found.

What was the size of your prostate? That is also a factor in a higher PSA.

brianjarvis | @brianjarvis | Feb 12 4:56pm

In reply to @kpg7121 "Thanks for the replies. What about driving after the procedure? The biopsy site is 50 miles..." + (show)

@kpg7121 If your biopsy is transrectal, be sure to get as much lidocaine as they can give you.

Also, if your biopsy is transrectal, they may give you Valium to relax you. If they do give you Valium, they might not let you drive yourself home.

For my 4th (& final) transrectal biopsy before treatment, my wife drove me there (45 miles) & back (45 miles). I had no problems with that distance.

Good luck!

kpg7121 | @kpg7121 | Feb 12 6:10pm

In reply to @jeffmarc "I had three biopsies and drove myself each time. Never was an issue. It is true..." + (show)

@jeffmarc I read the MRI report but I see no mention of the size of my prostrate, unless I'm missing something. The nodule is 3mm.

jeff Marchi | @jeffmarc | Feb 12 6:33pm

In reply to @kpg7121 "@jeffmarc I read the MRI report but I see no mention of the size of my..." + (show)

@kpg7121
It would usually be 35 cc to 60 cc the latter being somewhat enlarged. Some are even bigger.

kpg7121 | @kpg7121 | Feb 13 8:23am

In reply to @jeffmarc "@kpg7121 It would usually be 35 cc to 60 cc the latter being somewhat enlarged. Some..." + (show)

@jeffmarc There is a note on the report that says Volume 39.6 ml.

TommyG | @tdgillett | Feb 13 9:33am

I agree with the comments above. I'm due for my second transperineal biopsy next week. My MRI last week was pretty similar to the one I had last year prior to my biopsy. It was uncomfortable but not particularly painful. and yes, blood in the semen for several weeks afterwards. I have a large prostate and BPH which yields a higher PSA score (7.76 recently) but no dramatic increases (no doubling). Your jump from 3 to 4 is not alarming, but merits further investigation as you are having. I'm almost 80. Good luck.