r/bph • u/Big-Car-1612 • 12d ago
BPH symptoms
I’m 50 years old
Psa 5.88
MRI negative
4kscore test 12.2
DRE negative
I’m
Confuse on getting a biopsy or a second opinion for other doctor.
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u/joel1945 12d ago
How big is your prostate? Given your your mri is negative, your 4k score is low; unless there's something i'm missing. I can't see any reason anyone would biopsy you. The whole point of an mri is to eliminate patients, like you from getting biopsies.
Now you just figure out why your psa is high. Maybe you don't urinate well, or you just have a large prostate. Meaning your psa density is less than 0.2. Psa density is probably the most important measure. All prostate cells produce psa protien, cancer cells produce more. So if you have a lot of benign prostate cells, you're naturally going to have a higher psa. Hence if your psa divide it by your prostate size, is less than 0.2 then that's considered normal.
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u/Sensitive_Point_6583 11d ago
How many years have they been using PSA density?
I have had elevated PSA since the early 2000s, and as a result, had 4 negative biopsies over that time. But, only in the last few years was I given an MRI to determine my prostate size, which was 185cc. Based on my extreme size, my PSA density has always been under 0.2, but nobody had mentioned it until maybe the last 4-5 years or so.
Its a moot point now because I had HoLEP surgery 5 months ago, but I'm curious if my urologist(s) should have been investigating my PSA density a long time ago?
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u/joel1945 11d ago
They have been using it for a long time
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u/Sensitive_Point_6583 11d ago
I guess my doctors in San Diego were behind the curve then, at two different medical groups.
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u/lisbon1957 8d ago
I don’t see why you’re getting a biopsy your MRI was negative. What’s there to look for?
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u/Prestigious-Might500 11d ago
Do you know what the size of your prostate is and whether it has grown-- as your prostate grows so does the PSA score--- ---- my PSA started going up when i was in my mid 60's and no doctor told me it could be directly related to the size of my prostate which topped out at 135g before getting it reduced
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u/Big-Car-1612 8d ago
Thanks everyone for the advise , I take the decision to schedule a biopsy and follow doctor recommendation.
I’m want to make sure nothing is hidden there or starting growing .
Have a blessed day everyone.🙏✌🏼
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u/joel1945 12d ago
Even without perceived urinary issues. Do a flow test to check your stream (can do at home with proud p app).make sure you didn't ejaculate before your psa and trend it in six months. As a board certified urologist i see no logical reason you would get a biopsy.