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Transperineal Biopsy

I'm scheduled for transperineal biopsy soon thanks to PSA going back up again from 3.9 to 5.3 in 12 mos and fPSA down to 13% from 15 in same time period. Had really bad experience with a transrectal biopsy 5 yrs back with completely diff Dr (I felt everything during procedure - told that Dr he was blessed my arms were short because if they were long, my hands would be wrapped around his neck squeezing harder and harder with each piece of tissue he took out :) ). Even though this time it is with a diff much better Dr, this time I requested the transperineal version where I'm under general anesthesia.

Anyone have this type of biopsy done recently? Any complications? What was recovery like?

Thanks,
Dallas in SAT

Re: Transperineal Biopsy

I had a transperineal biopsy in May 2015. At the time my PSA was 5.8 with a fPSA OF 13%. My recovery from the general anaesthetic was fine and I took things quietly for a few days afterwards. For a few days my urine was bloodier than I expected ( more like a claret rather than a rose wine ) but overall the experience wasn't too bad. Hope your procedure goes well.

Best wishes.

Lyn

Re: Transperineal Biopsy

Thanks for the response. Current Dr is really good - Dr Naveen Kella in San Antonio TX. I'm sure it will go fine - coming up in couple days. They are telling me they should have the results in 5 business days.

Re: Transperineal Biopsy

You might want to consider a 3T-MP-MRI prior to your biopsy. You could then have a fusion biopsy where the MRI images are fused with Ultra Sound images and suspicious areas are targeted. 93% detection rate vs 52% with blind biopsy.

Fred

Re: Transperineal Biopsy

Thanks for the response. There is one facility I found online that provides 3T-MP-MRI in San Antonio TX where I live. My biopsy is scheduled to occur in 4 days. Will get with my Dr office first thing tomorrow and see if they are open to getting that done and if they can get it done in time prior to the biopsy.

Re: Transperineal Biopsy

We actually got 3T-MPMRI done yesterday. This AM, 6 hrs before my biopsy was scheduled, Dr called me and recommended cancel the biopsy for today. The MRI was very good quality and there were no areas indicating problems - clean with Prostate walls intact.

Still don't know cause of free PSA dropping to 13% and Dr is still concerned on that point particularly since I have no symptoms. We will do another set of blood tests in 3 months and if numbers come back worse, then we will figure out next step and may do another 3T-MPMRI then to see if anything new pops up since previous one.

Thanks again for the info! Dodged an unnecessary biopsy today thanks to that info!

Re: Transperineal Biopsy

Update: Tests from 8/3/2017 show PSA increased from 5.1 (Jan 2017) to 5.8 and free PSA went from 13% (Jan 2017) to 16%.

Per Dr request have appt with him 8/22 to discuss using the MP MRI from May 2017 and do transperineal biopsy as he is concerned the PSA continues to rise and free PSA is still too low.

Not sure why he wants to use the MRI from May 2017 since it showed "clean". I'm thinking Active Surveillance and wait until May 2018 and do another MRI and PSA tests then.

Thoughts?

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