May 22, 2017
How much to wait between biopsy and prostate surgery. Ideal duration between biopsy and prostatectomy.
STUDIES SUGGEST A SMALL WAIT CAN IMPROVE SOME OUTCOMES
“Those who had a TP within six weeks of the biopsy were less likely to have a bilateral nerve sparing procedure.” [Source] [Source is credible – a paper called Total prostatectomy within 6 weeks of a prostate biopsy: is it safe? by Kishore T. Adiyat; Manoharan Murugesan; Devendar Katkoori; Ahmed Eldefrawy; Mark S. Soloway of the Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA]
“Open RP shortly after prostate biopsy does not adversely influence surgical difficulty or efficacy, but RARP relies solely on visual cues rather than tactile sensation to determine posterior surgical planes of dissection. Our data suggest that RARP should be delayed after prostate biopsy; RARP within 6 weeks of biopsy was associated with a greater risk of complications even when controlling for disease and patient characteristics.” [Source] – NOTE: THIS LIMITATION DOES NOT APPLY TO OPEN SURGERY [paper: Interval from prostate biopsy to robot-assisted radical prostatectomy: effects on perioperative
outcomes by George L. Martin, Rafael N. Nunez, Mitchell D. Humphreys, Aaron D. Martin, Robert G. Ferrigni, Paul E. Andrews and Erik P. Castle Urology, Mayo Clinic Arizona, Phoenix, AZ, USA]
DOCTORS WHO BELIEVE IN 6-8 WEEKS DELAY AFTER BIOPSY
“Q: How long do I need to wait after my biopsy to undergo a robotic prostatectomy?
A: Dr. Miller recommends a minimum waiting period of 8 weeks following biopsy prior to proceeding with robotic prostatectomy. Significant inflammation occurs after a prostate biopsy resulting in temporary distortion of the anatomy (particularly when operating under such extreme magnification). Since prostate cancer is such a slow growing disease, this relatively short wait does not impose an appreciable risk.” [Source]
“repeated biopsies can make it more difficult to perform nerve-sparing surgery.” [Source] – meaning that biopsies do impact the ability to identify nerves.
The doctor below suggests 6 weeks (for inflammation to be healed).
What should you do during this six weeks?
KEGEL exercise should be conducted prior to the surgery [Source]
This is a slow growing cancer so a few weeks here and there will make no difference now. If it turns out after the op that it has spread, it has in all likelihood already done that – and not in the few weeks since your pSA test. Cancer doesn’t wait quietly until it is diagnosed and then go on the rampage [Source]