First Ultrasound w/o Biopsy?

Had 3 biopsies, and none included an ultrasound first.

had an ultrasound 6 years ago for another issue.

Had no ultra sound prior to by biopsy.

I had 3 PSA tests and a test to see if I was having voiding issues which turned out negative.

I wonder if this was merely some of the silly "legaleese" type of language they put in agreements just to cover themselves while also knowing that there would be a biopsy included. Could just be something where they like to have all their bases covered.

In any case, I certainly would not trust a mere ultrasound exam. After my uro performed a 20 core biopsy (ultrasound guided, of course), I asked him if he had seen any suspicious areas on the screen and he said "no." This gave me a confident feeling that the report would be fine.

Turned out that PC was found despite what the ultrasound suggested. So it takes a real biopsy to do a dx. Mere ultrasound images, without taking actual samples, are not enough.

Take care,
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.

All of mine were US-guided. They did look around first. I watched on the screen as they moved it around, and asked questions like "what's that white thing?" "a calcification" "what are those?" "seminal vesicles." I'm sure the urologist wished she'd given me anesthesia.

Finally she said, "nothing obvious, but that doesn't mean anything," and started pulling cores.

Since my original thread prompted this thread I guess I should respond.
Peter is correct, kabuki theater at it’s finest. I didn’t get the biopsy for another reason but doctor had plans to do it all along. Biopsy will be done next Thursday.

GP suggested a visit to the uro after a +DRE in 2006. Uro did ultrasound and note a vascular (large pulsing vein) abnormality and did NOT continue with the biopsy. So everyone dismissed my PSA Rising from 1.8 to 3.5 then 4.1. Until the new GP noted a 6.5 PSA in 2011. Too darn Late.

wampuscats

Peter I agree with you. It's pretty obvious you cannot see much with a standard ultrasound unless you have a major tumor. The only cases I'm aware of with no biopsy is Dr Bahn who will only biopsy if he sees something. He uses a power color doppler which is many times more powerful than a standard grey scale ultrasound. His philosophy is that if he can't see it then it won't hurt you. If you biopsy with a sampling templet you will only find indolent cancers, because large aggressive tumors need blood flow in order to grow. this increase blood flow shows up like a red blob on the color doppler and if it matches the tissue harmonics of a tumor on the ultrasound the area is biopsied.
When doctor Bahn did my 13 biopsy it was the most through biopsy I ever had. He spent over 20 min just looking and taking notes before he ever used a needle. It was pretty funny as he was saying in his Vietnamese accent that he was going to hit a spot that only two doctors in the world could hit and he was one of them. Then he would jump up and down saying I hit it; I'm a good shot; no one could hit that spot. He did this three times and was clearly pleased at his accuracy. I'm thinking, great, this is the forth time I've been shot by a Vietnamese, and I'm sure glad they weren't as accurate as he was. The three spots he hit were all positive and given the fact that 4 other doctors had taken over 150 core samples and hit nothing, to say that I was impressed with his skill would be an understatement. They say he is the best and my experience would confirm that.
JohnT