{"id":1752,"date":"2017-09-26T05:28:25","date_gmt":"2017-09-26T05:28:25","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/?page_id=1752\/"},"modified":"2026-04-21T23:20:15","modified_gmt":"2026-04-21T23:20:15","slug":"prostate-biopsy","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/prostate-cancer\/prostate-biopsy\/","title":{"rendered":"Prostate Biopsy for Elevated PSA and Abnormal DRE in NYC – Prostate Cancer Specialists"},"content":{"rendered":"

Prostate Biopsy – Top Specialists in NYC<\/strong><\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

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If you have any questions, to schedule a consultation<\/a>, please <\/a>contact us<\/a> or call\/text: 1-646-663-5515<\/span><\/a><\/strong>.<\/strong><\/p>\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  Find out our office hours or directions to our office<\/a>. <\/strong><\/span><\/p>\n

We offer affordable appointment prices<\/a> with or without insurance.  <\/strong><\/span>Same-day virtual video appointments<\/strong> and in-person appointments<\/strong> are available.<\/span><\/p>\n

Dr. Shteynshlyuger, MD, <\/strong><\/a>is a board-certified urologist in NYC who specializes in treating men with elevated PSA, prostate cancer, urinary, and sexual problems.   He has performed hundreds of prostate biopsies, including ultrasound-guided transperineal and transrectal MRI-fusion prostate biopsies, prostate surgeries, and many other procedures.  <\/strong><\/p>\n

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Minimally Invasive Prostate Biopsy for Men in NYC with Elevated PSA and Abnormal Prostate Exam (DRE)<\/h2>\n

Prostate Biopsy: What You Need to Know<\/h2>\n

\"\"Studies have shown that a 12-core prostate biopsy<\/strong> can efficiently detect most prostate cancer while minimizing complications. Prostate biopsy with fewer than 12 cores runs the risk of missing prostate cancer.<\/p>\n

For men with a very large prostate gland<\/strong>, 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.<\/p>\n

For men with abnormal prostate MRI findings of suspicious lesions<\/strong><\/span> that may represent clinically significant prostate cancer, we offer MRI fusion prostate biopsy<\/a>.  MRI fusion prostate biopsy can be performed transperineally or transrectally, under local anesthesia or IV sedation.<\/p>\n

When Should a Prostate Biopsy Be Performed?<\/h2>\n

Several factors go into the decision<\/strong> of whether or not a prostate biopsy should be performed. <\/p>\n

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 PHI, 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.<\/p>\n

Do I Need an MRI-FUSION Prostate Biopsy?<\/h2>\n

MRI of the prostate is often recommended for men with elevated PSA to risk-stratify men with elevated PSA.  If a suspicious lesion is visible on an MRI of the prostate, biopsying that lesion increases the rate of detection of prostate cancer.  If there is no suspicious lesion (PI-RADS 3 or greater) on the MRI, then MRI Fusion biopsy is not needed.<\/p>\n

Where to Get a Prostate Biopsy and an Evaluation for Elevated PSA in NYC?<\/h2>\n

At New York Urology Specialists, we offer treatment for men with abnormal PSA, abnormal prostate MRI reports, and prostate cancer<\/strong>.  Same-day virtual video appointments<\/strong> and in-person<\/strong> appointments are available.<\/p>\n

Call\/text today: 1-646-663-5515<\/span><\/a> <\/span><\/strong>or <\/span>make an appointment<\/span><\/a> online.  <\/span><\/span><\/strong><\/p>\n

We perform procedures such as prostate biopsy<\/a>, transrectal prostate ultrasound, hydrogel insertion prior to radiation therapy (SpaceOAR<\/strong>), prostate surgery, prostate enucleation for enlarged prostate, and the Urolift procedure<\/span>. We treat prostate cancer, urinary problems<\/a>,<\/strong> and erection problems<\/a>,<\/strong> and offer comprehensive testing<\/a><\/strong> for infections. We offer confidential<\/strong> appointments.<\/span><\/p>\n

Our appointment costs<\/a> are affordable with or without insurance<\/strong>.  We offer free insurance verification<\/strong>.<\/p>\n

Prostate Biopsy: What to Expect<\/h2>\n

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<\/strong> will be given. Transrectal prostate ultrasound will be performed, and an injection of pain medications will be administered around the prostate.<\/p>\n

The prostate biopsy will be performed, which usually takes less than 15 to 20 minutes.<\/p>\n

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.<\/p>\n

Does Health Insurance Cover the Cost of Prostate Biopsy?<\/h2>\n

All health plans cover the cost of traditional prostate biopsy and ultrasound-guided MRI-fusion biopsy.<\/p>\n

Cost of Prostate Biopsy <\/h2>\n

At New York Urology Specialists, for patients without health insurance, we offer an affordable prostate biopsy under local anesthesia that includes the cost of the follow-up visit.<\/p>\n

The cost of a 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.<\/p>\n

According to Fair Health, an independent healthcare pricing authority, the cost of a prostate biopsy in New York City is as follows:<\/p>\n

$3,481<\/strong> when performed under general anesthesia in a hospital with in-network insurance.<\/strong><\/p>\n

Our Discounted Price:<\/span> <\/strong><\/h2>\n

$950 includes prostate biopsy, local anesthesia, in-office antibiotics, and 1 post-prostate biopsy visit. <\/h2>\n

MRI-Guided Prostate Biopsy (not including MRI): $2,500 under local anesthesia; $4,500 under IV sedation.<\/h2>\n

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.<\/strong><\/p>\n

For men who have an identifiable lesion in the prostate<\/strong> that was detected on the MRI, 2 options for MRI and ultrasound fusion biopsy are available.<\/p>\n

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

Prostate MRI-guided ultrasound fusion biopsy<\/strong> 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 have had a negative prior biopsy or a very small suspicious focus of less than 0.5 cm on the prostate MRI and a relatively low PSA level.<\/p>\n

Saturation Prostate Biopsy<\/h2>\n

Saturation prostate biopsy<\/strong> is performed when an initial biopsy showed no prostate cancer, but clinical features (rising PSA) suggest an increased risk of prostate cancer.<\/p>\n

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.<\/p>\n

Prostate Biopsy Options: Transrectal vs Transperineal<\/h2>\n

We offer both transrectal and transperineal prostate biopsy options. Transperineal biopsy is associated with a lower risk of infection.<\/p>\n

Benefits of transrectal include lower costs, can be more readily performed under local anesthesia in an office setting, and highly effective for most lesions. <\/p>\n

The biopsy approaches\u2014transrectal or transperineal\u2014each has distinct advantages:<\/p>\n\n\n\n\n\n\n\n\n\n
Feature<\/strong><\/td>\nTransrectal Biopsy<\/strong><\/span><\/td>\nTransperineal Biopsy<\/strong><\/span><\/td>\n<\/tr>\n
Access route<\/span><\/td>\nNeedle passes through the rectal wall<\/td>\nNeedle passes through the skin of the perineum (area between scrotum and anus)<\/td>\n<\/tr>\n
Infection risk<\/span><\/td>\nHigher (0.9% sepsis rate typical; requires antibiotics)<\/td>\nMuch lower (nearly 0% sepsis; often no antibiotics needed)<\/td>\n<\/tr>\n
Access to prostate<\/span><\/td>\nGood for posterior areas; may miss some anterior\/apical lesions<\/td>\nExcellent for all areas, including anterior and apical zones<\/td>\n<\/tr>\n
Anesthesia<\/span><\/td>\nUsually local anesthesia; office-based<\/td>\nLocal or general; increasingly office-based with modern techniques<\/td>\n<\/tr>\n
Patient comfort<\/span><\/td>\nModerate discomfort during\/after<\/td>\nGenerally well-tolerated; minimal post-procedure issues<\/td>\n<\/tr>\n
Other benefits<\/span><\/td>\nQuick and widely available<\/td>\nReduced antibiotic resistance concerns; cleaner approach<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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Preparation for Prostate Biopsy<\/h2>\n

At New York Urology Specialists, we require that a patient have a negative urine culture<\/strong> prior to a prostate biopsy. Patients with urinary retention or who have a catheter will usually have persistent bacterial colonization. In this situation, we will pretreat the patient to minimize the risk of infection.<\/p>\n

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.<\/p>\n

Men who will be getting IV sedation or general anesthesia will need to fast for at least 8 to 12 hours prior to the procedure.<\/p>\n

UTI and Elevated PSA<\/h2>\n

It is important to exclude active urine or prostate infection<\/strong> as a cause of PSA elevation. Men who have an active infection (symptoms of UTI, cystitis, urethritis, or prostatitis, and a 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.<\/p>\n

Elevated PSA and Antibiotics<\/h2>\n

Studies show that elevated PSA in the absence of urinary tract infection symptoms of prostatitis should not be treated with antibiotics,<\/strong> as the incidence of prostate cancer is not changed. Small changes in PSA can occur, but are of no value.<\/p>\n

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<\/strong>.<\/p>\n

Should Another Biopsy Be Performed if I Had a Previous Biopsy that Showed No Prostate Cancer?<\/h2>\n

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 the need to minimize unnecessary biopsies and maximize the chances that dangerous cancer does not get overlooked.<\/p>\n

There are several tools<\/strong> urologists use to help us to decide whether or not to recommend a second biopsy.  Certainly, the progression of symptoms<\/strong> and change in PSA levels<\/strong> 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. <\/p>\n

Studies such as prostate MRI<\/strong> 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.<\/p>\n

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<\/strong>.  Fortunately, diligent urological follow-up usually identifies these men for repeat prostate biopsy and eventual diagnosis, allowing timely initiation of treatment.<\/p>\n

Risks of Prostate Biopsy<\/h2>\n

A prostate biopsy is associated with a 2 to 3% risk of severe infection, sepsis, which may require hospitalization.<\/p>\n

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.<\/p>\n

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

Sex after Prostate Biopsy<\/h2>\n

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.<\/p>\n

Did you know?<\/strong><\/span> Dr. Shteynshlyuger<\/a> <\/strong>has performed over 1,000 prostate, penile, and bladder surgeries,<\/strong> including prostate biopsy, prostate removal, penile implants, Urolift, prostate enucleation, correction of Peyronie’s disease, and MRI fusion biopsy.<\/p>\n

Cost of Prostate Cancer Treatment without Insurance<\/h2>\n

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

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<\/strong>.  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<\/strong>.<\/p>\n

Cost of Prostate Cancer Treatment and Insurances<\/h2>\n

\"InexpensiveAt New York Urology Specialists, we offer affordable treatment for men<\/strong><\/a>. Our prices are low<\/strong> for patients without insurance<\/strong><\/span> and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. <\/p>\n

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

Why Choose New York Urology Specialists for Prostate Cancer Treatment?<\/h2>\n