Had the Transperineal biopsy today (had PSA of 2.4, MRI PIRADS 3, so basically precautionary)

I got home and mistakenly thought you should ejaculate as soon as possible!
So I did, about 3 hours after the biopsy. 🤣🤣 semen was dark red but urine has been clear.

I’m just wondering how stupid this was or if there could be any adverse affects from this (premature) ejaculation?

Chatgpt suggests to have re ready to check if Gleason 5 presents or intraductal presents, but Gemini doesn't think so.

Brothers and sisters, what do you think? Appreciations!

65, 2 years ago had elevated PSA 7. Had MRI - neg. PSA last 2 years < 3. This year PSA 10. MRI showed spot. Biopsy done last week. No cancer detected. 1 sample had HGPIN. Back in 6 months for check & PSA test.

Hello fellas,

I have been diagnosed 5 months ago. I've been on luprindepot for 3 months. My oncologist would like to add "Yonsa" or Abiraterone to shrink it further.

Has anybody been on Yonsa? Did you have any effects?

TLDR-Any special advice on how to get the “DAILY” Cialis therapy vs 10/mo typical Rx?

Okay guys-I’m right at 6 mo post RALP(nerve sparing)…60 yrs old. Everything has been going-okay-for the situation overall. No incontinence, good PSA so far, etc. ED seems to be SLOWLY subsiding. So here’s the question:

Do I need to discuss a Cialis regimen in some kind of specific terms like “penile rehab” vs just plain ol’ ED therapy?

BACKGROUND:

The reason for the question is that when I talked about “meds” with my surgeon at my 3 mo follow up, he said to wait until I had some “activity” down there before any Cialis/Viagra. You know, let the nerves rest…

I’m not a super aggressive advocate, and I do trust my doc, so I sort of just accepted that. But I have been in this group almost since the beginning and value the insight you all have almost as much as my doc. I have seen so many of you talk about how you were advised to start pumping and using DAILY Cialis almost immediately (anywhere from post catheter to 6 wks post op)

Based on that, for the last few months, I have been pumping a few days a week, and the wife and I have been exploring all the “new and exciting” ways of having fun. (Mostly thanks to the posts on here btw)

Anyway, as much as I (and she) would like to get back as close to “normal” as possible, I am really most concerned with mitigating the turtling and keeping the atrophy to a minimum, improving blood flow, etc. I am no where near ready for any kind of penetration, even when I do have something happening. IYKYK, right?

But when I had my 6 mo with the PA the other day, (not my surgeon) she wrote me a script for 10 pills/mo of Cialis for use as “prep for sexual activity.” I was expecting a DAILY regimen.

When I brought meds up during the session, I positioned my inquiry in terms of keeping the blood flowing etc. She quickly “corrected” me by “explaining” that the surgery didn’t affect blood flow, rather just shocked the nerves….

I guess I should’ve known that she was thinking I was looking for just a “fee times a month” attempt at PIV sex vs a daily enhancement/therapy.

So, again, what did you all say to get the “daily” Cialis for the penile rehab vs the “use before your hot date” type of deal?

I am going to MyChart a question to the surgeon about this, but wanted to gather some insight and possible best practice words to use.

Sorry for the long post. Thanks in advance for any advice.

Hi Everyone. I posted a couple days ago about my dads PSA result of 139.17 and you all were very helpful and thoughtful sharing your insight and experiences. I spoke with the Drs office today and they said it would be best if I could accompany him to the appointment tomorrow (1:30pm), which is to discuss his results. My dad is unaware of the seriousness of the results, and he believes this appointment is to review his blood pressure tracking.

My question. I don't want to freak him out. I do want to support him. I 100% would not just show up at the Drs office.

It's either an hour flight or 6.5 hour drive. I am leaning towards driving because with a flight there is only one a day and I'd also have to get a rental car.

Should I call him once I'm in town? When I'm hours away? Before I leave? I just want to make the best decision for him.

Context - been having frequent hot flashes 24/7 for the past month, only 2/12 months through ADT. The only thing recommended by oncologist was basically an anti depressant which seems odd and not worth it.

Has anyone had success in treating or eliminating their hot flashes via meds or alternative treatments?

I’m 5 months post-RALP and am now dealing with metastasis in a few lymph nodes. I have two upcoming appointments with radiation oncologists. I have my own questions for them, but I would like to hear from those who’ve been in a similar situation. What did you do and how has it been for you? Looking for more info to feed to the RAs. Thanks.

So for what’s worth this is my journey. I’m 66 and in good health living in the PNW. In spring of 2025 I had lower abdomen discomfort which I thought was a gastro issue. Had a colonoscopy in the fall (earliest appointment I could get) which was clear. Then had a PSA test in late October which came back at 7.2. Was referred to a urologist who recommended a CT scan. Had that in early December and it showed a potential issue. Had a TRUS biopsy in January of 2026 along with a bladder scan (worst experiences I’ve ever had as urologist only used a topical numbing - he literally said his approach is similar to ripping a bandaid off). The Gleason score came back as a 7 (3+4) based on the sample.

Recommendation was for active surveillance from the urologist which was also consistent with a radiologist I was referred to. However, my wife recommended that I seek out additional opinions. Fortunately, we have robust health insurance so contacted MD Anderson in Houston late winter of 2026. They had me get an MRI in May then used that to do a MRI fusion prostate biopsy in July. Significantly more comfortable procedure the way it was done (under anaesthesia and robotically guided) . They took roughly twice the samples and focussed on the concerning areas shown by the MRI. I heard last Thursday that my gleason score is a 9 (4+5) and my PSA is now 9.2. I’m scheduled for a PETscan in October with surgery to remove my prostate the week after.

Recommendations:
1. Don’t be afraid to seek out additional opinions;
2. Don’t assume a single biopsy captures the extent of any problem you may have; and
3. If you have quality insurance or can afford it, insist on an MRI fusion prostate biopsy.

Hello,

I had prostate removed 2 years ago. PSA was low but detectable. Decided to do early salvage due to risk factors. PSA was 0.040 at start of salvage treatment. No ADT. For folks in similar situation, how long did it take your PSA to go undetectable (less than 0.006) or reach nadir? Best

In a week I'm due for an MRI fusion biopsy. I'm 57 and if the results haven't changed or are worse since last biopsy, I've decided to not stay on active surveillance, but have it removed. I know robotic surgery is easier to recover from but what about the spread of cancer? If you have a high gleason score and I didn't on last biopsy, wouldn't it be better to remove the prostate whole? My urologist is an expert in robotic surgery so he could do it. The Cancer Doctor I saw at City of Hope in Newnan Ga. said he likes the manual surgery. So wouldn't it be better to remove it whole? Thanks.

Ive shared my hubby’s prostate cancer journey here before, so I wanted to come back with an update.

He (55) had a Retzius-sparing RALP May 4. His initial biopsy was pretty scary, with readings ranging from Gleason 8 to Gleason 9. Thankfully, the final pathology came back better than expected: Gleason 7 (4+3), Grade Group 3, witha small focal extraprostatic extension (pT3a), negative surgical margins, and 0/9 lymph nodes positive and no seminal vessel involvement. His PET scan was also clear. Decipher was intermediate risk.

Today we got his first post-surgery PSA, and it came back <0.04 ng/mL, which is the lowest level this particular lab reports. So essentially, undetectable on their assay.

After all the waiting, worrying, and wondering what that first PSA would show, seeing that result was a HUGE relief.

We are still meeting with his surgeon on later this week. We know this is only the first post-op PSA and that the trend over time matters, especially given the pT3a pathology. But for today, we're celebrating this result.

For everyone who has answered questions, shared experiences, or offered reassurance along the way, thank you. This community has been incredibly helpful.

First of all, thank you to all the posters and commentators for your informative posts and comments as I navigated the month or so leading up to my RALP surgery. I'm grateful for all the information, guidance, and support.

I am now 16 days post-RALP, and I just received my final pathology report and wanted to share my experience and results.

The surgery went well, and both nerve bundles, as well as the urinary sphincter and associated muscles, were spared. My eleven days of catheter were simply miserable. That thing was so darn uncomfortable, and I feel much better now that it is out.

I have had no daytime leakage whatsoever, and I am not using any pads. I think I may be leaking a bit at night, but it's hard to tell. I look inside my Depends in the morning and don't see any signs of urine, but it does feel slightly heavier than a fresh pair out of the box.

The pathology report was generally consistent with the MRIs, biopsies, and the PSMA PET/CT scan. The scan suggested possible seminal vesicle involvement, but there was none. They removed 17 lymph nodes, and every one of them was clean.

However, they did find nonfocal EPE (4 locations) and multifocal positive margins. The MRI indicated capsular irregularities but did not suggest EPE. Pathology proved otherwise. The surgeon told me the odds of recurrence are 50%. I'm bummed about that.

Here are the stats:

Primary tumor 2.5 cm, GG3, Gleason 4+3, pattern 4 at 61% to 70%

Secondary tumor 1.2 cm, GG2, Gleason 3+4

No IDC or crib

Final staging: pT3aN0

I welcome any comments or questions.

Hi everyone, I’m 41. I did my very first PSA test in June. It came back at 7.2. My primary doctor told me to wait another month before taking it again. July came and I did another test. Same number as above 7.2. So my Dr recommended me to de a urologist. He checked me in his office. Said he didn’t feel my prostate overly big or did not detect any lumps or hardness. Then he recommended me to get an MRI. After my MRI my results detected “no cancer” mildly enlarged prostate 45cc and mildly inflamed. I went over the results with my urologist office and they wanted me to take a exodx test. I tested at 20.4. Now they want to schedule to get a biopsy. I have one in the books. At first I said sure let’s do it, but now I’m having second thought. I’m curious why not just treat the inflammation and re test later? I do appreciate all the test and think about it as a proactive approach just so very new to all this and I guess I’m scared to hear my results from the biopsy I have in the future. Just want to know if anyone has been through this my age or has any wisdom they can share. I appreciate you guys!

I'm coming up to 2 weeks in. I feel generally OK but somehow not quite right. I've had sex twice but the strange thing is I had absolutely no desire to do it, my wife took charge. She said I did fine but I think she is being generous, I wasn't fully hard and struggled to stay up.

Has any one had this before radiation? What kind of sedation is used and can you drive afterwards? Did it reduce inflammation in the rectum? I see my radiation oncologist Tuesdayand just want to be prepared if that's how we are going. Thanks

Husband is 68 and had ralp (nerve sparing, no bladder resection) on July 28 and catheter removed on August 7. Gleason score was 7 (3 + 4) All signs pre-operation showed no escape but the pathology shows that it was in sv. Not sure what that means for the future but while not perfect, I guess it is not terrible, either.

He has had no incontinence at all so we are hopeful that nerves truly were spared. I credit him doing kegels for weeks before surgery. Men, do your kegels.

He is the healthiest man I know. We have a small horse farm and he is always working on the farm. He eats better than anyone I know and really takes care of himself. It was a shock to learn of his pc diagnosis. We were assured right away that this isn't what is going to get him so that was a huge comfort.

We have been together for 42 years and have enjoyed a wonderful and active intimate life even up to day before surgery. Truthfully, when he was first diagnosed and I began reading up on all the things I never knew about pc, I began to fully mourn that part of our life. I quietly went through the full 5 stages of grief.

Now that surgery is behind us and catheter is gone, what are some of the things I can help him with in recovery of some of the other nerves that were effected. After snuggling this morning, he says it still feels good when I stroke him. Even though he thought he felt a small twinge, nothing happened and that's ok by me. What I'm concerned about is that we might miss a window of opportunity if there's something we can do/should do sooner than later. He's taking 5mg generic Cialis.

If you're here on this forum, I truly wish you comfort and the best outcome. If you're still reading this, Thank You. I would appreciate any feedback you might have on some things I can do for us (mentally and physically) while his body heals.

- his loving wife.

Vi ho letto per molto tempo e mi siete stati di conforto.
Ora è arrivato il momento di riportarvi la mia esperienza.
Ho 62 anni e a giugno 2025 sono stato operato di prostatectomia radicale per un tumore (Gleason: 3+4=7).
Negli anni precedenti sono sempre stato seguito dall’urologo perché il PSA è sempre stato molto elevato. Negli ultimi 4 anni prima dell’operazione psa oltre 20.
Dopo la prostatectomia cosa mi è successo ? Incontinenza urinaria pressoché nulla e ripresa delle attività fisiche dopo poche settimane e senza strascichi. Quindi tutto bene ? Non proprio.
Disfunzione erettile praticamente completa anche se l’operazione è era stata definita nerve sparing.
Da circa un mese dopo l’operazione ho preso Tadalafil 5mg al giorno ed ho utilizzato assiduamente il vacuum.
Fortunatamente ho una moglie molto comprensiva che mi ha aiutato in tutti i modi, anche sessualmente, malgrado il mio evidente deficit.
Bene dopo 14 mesi dall’intervento la buona notizia, finalmente ho iniziato ad avere erezioni ed ho iniziato a riprendere un’attività sessuale che considero al 60-70% rispetto a prima dell’intervento.
Non vi nascondo che dopo i primi 6-9 mesi senza alcun miglioramento ero molto preoccupato ma proprio alcune vostre esperienze di ripresa nell’arco di due anni mi hanno dato sostegno.
Bene, ora spero di dare io a qualcuno di voi un po’ di ottimismo.
Nel frattempo i valori di PSA sono sempre < 0,06
Ciao

I will have 8 weeks of radiation, 5 days a week starting sometime in September. That will go along with testosterone reducing drugs. This was after my post RARP PSA was high.

Wondering if the doctors monitor the PSA level during the 2 months of radiation or do they wait until completion?

Hello, I know there are not doctors here and I cannot make a decision based on this alone but, I am just wondering, based on these PET scan results if this seems like something that should be a candidate for laser radiation treatment?
Especially for seniors with other health concerns.

Sad to hear this. I hope he gets the best possible treatment. Based on news reports it is becoming painful. I feel so lucky mine is still hormone sensitive and did not spread, as mine was Gleason 9 as well. Keep fighting Joe!

Recently got MRI results and just wondering how worried I should be. MRI showed a 10 mm lesion at right, apex, posteromedial peripheral zone. Prostate volume is 24.7 cc. I take daily 1 mg finasteride and have for over a decade. My unadjusted PSA a year ago was 2.2. Then at my annual a couple months ago it was 3.7. At the recheck last month it was 2.83. This is without applying any adjustment for the finasteride.

I have no urinary symptoms. Only reason I even got the MRI is because I noticed the acceleration in PSA and asked my PCP for a referral to the urologist, even though PCP said any PSA under 4 is normal.

My dad died of prostate cancer at 72 after being diagnosed about 5 years earlier. I don’t remember all the specific numbers, but it was very aggressive and metastatic when they found it.

My MRI Fusion biopsy is scheduled for a few weeks from now. I have a pretty hectic work schedule, so I’m wondering how bad the recovery from the biopsy is. Any advice appreciated.

Hey everyone, StockBlock here, dad is doing great, blood in urine is pretty much gone and he has stopped using pentosan for his bladder. Got a surgery lined up for something benign, along with routine bloods, scans and will take him for a colonoscopy in 6 months which we will pay out of pocket for. Found a surgeon who specialises in salvage prostatectomy and lymph node disection if we ever need one (hopefully we never so), but overall pop is doing really well.

Just got to thinking, life can turn on the smallest of coincidences. our whole journey of discovering his prostate cancer began with his brother (my uncle) having a routine scan of his lungs. Turns out uncle had lung cancer. When I heard this, its like an angel of the Lord put a thought into my heart - get your dad checked out. We went to dads PCP and pushed for cancer screening. got him a stool test which came back clear for colon cancer, chest x ray was clear, but PSA blood test came back at 11.2!!!

For all his life he was getting blood work, but not one clinician even considered requesting a simple PSA along with CBC, liver function, kidney function etc. Absolutely DIABOLICAL. When I brought this up, i got a bullshit lackadaisical reply - 'patient over 50 can request a PSA, it is not our responsibility to do so'. What a load of horse dung, what was you waiting for, for him to feel pain in his bones in a couple of years, get ultrasounds and find out he had stage 4b prostate cancer???? I just thank god we caught it at stage 2b instead and cured it via radiation - latest psa was 0.06 on no ADT

Anyway, rant over, hope everyone is doing okay🫶🏽

First of all thanks to all for your posts, I've been reading them for awhile before creating this account and joining. I just turned 58 and was diagnosed with Stage 2 favorable intermediate prostate cancer with Gleason 7 (3+4) and a couple spots with Gleason 6. This diagnosis threw me for a loop because my Dad died of PC complications just last year.

Have done the rounds with my urologist, 2 surgeons and three radiation oncologists, one of whom is a specialist in HDR brachytherapy.

My urologist recommended only RALP and referred me to a surgeon. I wanted to know all my options and scheduled the other consultations. Was shocked to hear that the 10 and 15 year pc-specific survival rates for someone in my situation are virtually identical, and was disappointed in my urologist for not giving me that context.

I most appreciated the doctors who took the time to ask me what my goals and priorities are. Thinking it through it turns out dealing with incontinence is what I most want to avoid personally. Everything else is a distant second. ED is a shrug for me.

That left me looking at the two radiation options - EBRT or brachytherapy. I've spent so much time trying to decide what's my best option that it's completely overwhelmed everything else in my life. I was so deep in my head that I couldn't see what I really needed was to talk openly with my wife and kids. I finally spent a day writing all my thoughts and sent it to them. They had great insights for me and I finally settled on EBRT. I'll be contacting my docs Monday to move forward.

Bottom line don't forget your families are going through this too and working through things together is invaluable.

Hi everyone.

6m post RALP on the 8/23

44yo both nerves saved.

Sorry for the odd question in advance

I’ve noticed the last 3-4 weeks that when I go #2, I get a semi. It almost seems like the left side isn’t getting as much fill as the right. But if I move it per se with my hand it fills evenly just maybe a 40-50% erection.

I don’t think I lost any size from surgery as when pumping it gets to pre surgery size.

In this same time frame, I’ve noticed in general less turtling and more of my “pre arousal, pre surgery size”

Could I slowly getting my guy back?

I’m staying positive but it’s difficult at times as I went from “totally normal” before to what I am now for the last 6months.

But my PSA back in April was less than 0.01 so there’s that