Prostate Biopsy – Top Specialists in NYC

by Alex Shteynshlyuger MD

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If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5515.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.

Dr. Shteynshlyuger MD is a board-certified urologist in NYC who specializes in treating men with elevated PSA, prostate cancer, sexual, testicular, hormonal, urinary, and sexual problems in men.   He has performed hundreds of penile and prostate surgeries, including penile implants, surgery for enlarged prostate, and many other procedures.  

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Minimally Invasive Prostate Biopsy for Men in NYC with Elevated PSA and Abnormal Prostate Exam (DRE)

Prostate Biopsy: What You Need to Know

Studies have shown that a 12 core prostate biopsy can efficiently detect most prostate cancer while minimizing complications. Prostate biopsy with less than 12 cores runs the risk of missing prostate cancer.

For men with a very large prostate gland, we usually increase the number of cores that we take from 12 cores to anywhere from 18-36 cores depending on the size of the prostate, to ensure adequate sampling of the entire prostate.

When Should a Prostate Biopsy be Performed?

Several factors go into the decision whether or not a prostate biopsy should be performed. 

A prostate exam, prostate size, PSA levels, family history of prostate or breast cancer, and findings on prostate imaging (MRI) and serum tests such as the 4K score help urologists decide whether or not to recommend a prostate biopsy.  The patient’s age and life expectancy should also be considered in combination with the previously mentioned factors.

Where to Get Evaluation for Elevated PSA and Prostate Biopsy in NYC?

At New York Urology Specialists, we offer treatment for men with abnormal PSA and prostate cancer.  Same-day virtual video appointments and in-person appointments are available.

Call/text today: 1-646-663-5515 or make an appointment online.  

We perform procedures such as prostate biopsy, transrectal prostate ultrasound, hydrogel insertion prior to radiation therapy (SpaceOAR), prostate surgery, prostate enucleation for enlarged prostate, and Urolift procedure. We treat prostate cancer, urinary problems, and erection problems and offer comprehensive STD testing for infections. We offer confidential appointments.

Our appointment costs are affordable with or without insurance.  We offer free insurance verification.

Prostate Biopsy: What to Expect

With the prostate biopsies performed in our office under local anesthesia, the men will come to our office. You will undress and lie down on the procedure table. An injection of antibiotics and pain medications will be given. Transrectal prostate ultrasound will be performed, and an injection of pain medications will be administered around the prostate.

The prostate biopsy will be performed, which usually takes less than 15 to 20 minutes.

He will be asked to drink some fluids and to urinate at least twice before you leave the office. Occasionally men may have difficulty urinating after the procedure and may require a temporary catheter.

Cost of Prostate Biopsy 

At New York Urology Specialists, we offer an affordable prostate biopsy under local anesthesia that includes the cost of the follow-up visit.

The cost of prostate biopsy at New York Urology Specialists is 70% less than at a hospital.  The cost does not include the cost of the pathological examination, which is billed separately by the laboratory.

According to Fair Health, an independent healthcare pricing authority, the cost of prostate biopsy in New York City is as follows:

$3,481 when performed under general anesthesia in a hospital with in-network insurance.

Our Discounted Price:  $950 includes prostate biopsy, local anesthesia, in-office antibiotics, and 1 post-prostate biopsy visit. 

MRI-Guided Prostate Biopsy (not including MRI): $2,500 under local anesthesia; $3,500 under IV sedation.

If the prostate MRI does not show a suspicious lesion, there is no need to perform an MRI/ultrasound fusion prostate biopsy as there is no clear benefit from doing so.  MRI does not contribute any value to the prostate biopsy if there is no identifiable suspicious lesion on the MRI.

For men who have an identifiable lesion in the prostate that was detected on the MRI, 2 options for MRI and ultrasound fusion biopsy are available.

At New York Urology Specialists, we typically perform cognitive fusion MRI biopsy for the initial prostate biopsy. This avoids to need for anesthesia and minimizes costs.  We have greater than 80% success in identifying prostate cancer present in the target lesion on the MRI.

Prostate MRI guided ultrasound fusion biopsy using a template perineal approach under general anesthesia is another option.  This is a more involved procedure that requires general anesthesia. It is beneficial for men who had a negative prior biopsy or a very small suspicious focus of less than 0.5 cm on the prostate MRI and relatively low PSA level.

Saturation Prostate Biopsy

Saturation prostate biopsy is performed when an initial biopsy showed no prostate cancer, but clinical features (rising PSA) suggest an increased risk of prostate cancer.

With saturation prostate biopsy, 2-3 times as many samples are taken from the prostate gland in an effort to detect prostate cancer. The procedure is otherwise identical to a traditional 12-core prostate biopsy.

Preparation for Prostate Biopsy

At New York Urology Specialists, we require that a patient has a negative urine culture prior to a prostate biopsy. Patients in urinary retention or who have a catheter will usually have persistent bacteria colonization. In this situation, we will pretreat the patient to minimize the risk of infection.

The patient is advised to have an enema prior to the procedure. The patient will also start taking antibiotics the night prior to the biopsy. The antibiotics will be continued for 5 days after the biopsy. Men can eat and drink normally when the biopsy is performed in our office under local anesthesia.

Men who will be getting IV sedation or general anesthesia will need to be fasting for at least 8 to 12 hours prior to the procedure.

UTI and Elevated PSA

It is important to exclude active urine or prostate infection as a cause of PSA elevation. Men who have an active infection (symptoms of UTI, cystitis, urethritis, or prostatitis, and positive urine culture) and have blood drawn during a UTI, which shows an elevated PSA level, should have a PSA test repeated in about 3 weeks once the UTI has been treated. If the PSA levels are persistently elevated, prostate biopsy should be considered.  Ideally, PSA should not be drawn in the presence of UTI. The PSA test should be performed 3-4 weeks after the infection has been treated.

Elevated PSA and Antibiotics

Studies show that elevated PSA in the absence of urinary tract infection symptoms of prostatitis should not be treated with antibiotics as the incidence of prostate cancer is not changed. Small changes in PSA can occur but of no value.

On the other hand, in patients with symptoms of UTI (cystitis, urethritis, prostatitis), antibiotic treatment is appropriate, and PSA should be taken 3 to 4 weeks after the UTI has been treated.

Should Another Biopsy Be Performed if I Had a Previous Biopsy that Showed No Prostate Cancer?

While prostate biopsies are generally safe, a small number of men experience significant adverse side effects from prostate biopsy, including infection and bleeding.  A urologist is faced with a need to minimize unnecessary biopsies and maximize the chances that dangerous cancer does not get overlooked.

There are several tools urologists use to help us to decide whether or not to recommend a second biopsy.  Certainly, the progression of symptoms and change in PSA levels can tip us one way or another to recommend a repeat prostate biopsy.  Timeframe or time from a prior biopsy is also taken into consideration. 

Studies such as prostate MRI can help stratify the risk of having prostate cancer in the context of other clinical factors such as baseline risk for prostate cancer based on age, PSA level, and family history.  Prostate MRI can help the urologist focus on the particular area of the prostate where high-risk prostate cancer is more likely to be found.

It is important to recognize that even with all the refinements that we have today, including prostate MRI, 4K score, and PHI test, 15-30% of men will harbor prostate cancer that is not picked up by prostate biopsy.  Fortunately, diligent urological follow-up usually identifies these men for repeat prostate biopsy and eventual diagnosis, allowing timely initiation of treatment.

Risks of Prostate Biopsy

A prostate biopsy is associated with a 2 to 3% risk of severe infection, sepsis, that may require hospitalization.

Most men develop a small amount of blood in the urine and a small amount of blood in the rectum after the biopsy. These resolved spontaneously within 1 to 2 weeks after the procedure.

Some men may see blood in their semen that can persist for up to 2 months after the procedure. This is not dangerous.

Sex after Prostate Biopsy

Men may resume sexual activity 2 weeks after prostate biopsy once there is no blood in the urine.  You might notice some blood in the ejaculate, which is not dangerous. You may use condoms to maintain ‘cleanliness’ during this period.

Did you know? Dr. Shteynshlyuger has performed over 1,000 prostate, penile, and bladder surgeries, including prostate biopsy, prostate removal, penile implants, Urolift, prostate enucleation, correction of Peyronie’s disease, and MRI fusion biopsy.

Cost of Prostate Cancer Treatment without Insurance

At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. 

At New York Urology Specialists, we offer flat-fee ‘all-cost-included’ procedures such as prostate biopsy, hydrogel SpaceOAR insertion, circumcision, no-scalpel vasectomy, testicular implant, vasectomy reversal, hydrocelectomy, varicocelectomy, and many more.  The procedures are performed in our office under local anesthesia or sedation. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.  Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles.

Cost of Prostate Cancer Treatment and Insurances

At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. 

We accept many health insurance plans.  We would be happy to verify your eligibility and benefits and provide you with detailed information on your health plan’s coverage.  Financing options and credit options are available to help you pay for medical care.

Why Choose New York Urology Specialists for Prostate Cancer Treatment?

• All treatment is performed by a board-certified urologist experienced in treating men with rising PSA, prostate cancer, enlarged prostate, erectile dysfunction, low testosterone, scrotal and testicular problems, and urinary problems using medical therapy, minimally invasive therapies, lasers, and surgery.  
• We are one of the few practices in the region to offer a full range of options for the treatment of sexual, urinary, and erection problems in men.
• We offer treatment options for side effects and complications of prostate cancer treatment including erectile dysfunction, Peyronie’s disease, urinary problems, frequent urination, and overactive bladder in our office.  Office procedures avoid the risks, costs, and recovery from general anesthesia.  
• We offer diagnostic testing in our office, which avoids hospital costs.
• Extensive experience: Thousands of men have been treated successfully for elevated PSA, prostate cancer, erection problems, and urinary incontinence.
• Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
• We are conveniently located within a 30-60 minute commute to men who are seeking treatment for testicular and penile problems, erectile dysfunction, enlarged prostate, urinary, and cancer treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

What do Prostate Cancer Problems Look Like?

You can find pictures of Prostate Cancer as well as before and after treatment images in our image gallery.

Scheduling Appointments for Prostate Cancer Treatment at New York Urology Specialists

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If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5515.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.

Dr. Shteynshlyuger MD is a board-certified urologist in NYC who specializes in treating men with elevated PSA, prostate cancer, sexual, testicular, hormonal, urinary, and sexual problems in men.   He has performed hundreds of penile and prostate surgeries, including penile implants, surgery for enlarged prostate, and many other procedures.  

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Treatment for Men With Fast Recovery at New York Urology Specialists

At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of men’s health concerns including high PSA, abnormal 4Kscore, abnormal prostate MRI, and prostate cancer.  We understand the challenges that sexual and urinary problems create for our patients with prostate cancer, their relationships, and their self-esteem.  We help you find a treatment for penile problems and urinary problems, including erectile dysfunction, that fit your needs, lifestyle, and preferences.

Urologists are doctors specializing in the treatment of men with prostate cancer, urinary, and sexual problems that include penis problems, scrotal problems, and erectile dysfunction. By virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for any problem that affects the penis.  We offer medical and surgical treatment for men’s sexual problems.

We Treat Some of the Most Complex Men’s Health Problems:

• Erectile dysfunction in men for whom oral pills do not work.
• Enlarged prostate
• Penile Pain During Sex
• Impotence in men with diabetes.
• Premature Ejaculation
• Peyronie’s Disease
• Burning during urination
• Urinary retention

Schedule an Appointment with Dr. Shteynshlyuger: Call/text today: 1-646-663-5515 or make an appointment online Dr. Shteynshlyuger is a fellowship-trained, board-certified urologist with expertise in the evaluation and treatment of prostate problems including elevated PSA, enlarged prostate, and prostate cancer.  He also treats side effects of prostate treatment including sexual, urinary, and erection problems in men.  He uses modern, effective, and proven treatment methods.  We offer prostate biopsy, treatment of localized and metastatic prostate cancer with surgery, immunotherapy, radiation therapy, and chemotherapy.  We also offer inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease. We perform procedures such as hydrogel insertion prior to radiation therapy (SpaceOAR), Rezum for BPH, prostate enucleation for enlarged prostate, and Urolift procedure.   He has successfully treated hundreds of men with a nodular prostate, elevated PSA, prostate cancer, and erection problems. He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.

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If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5515.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.