OpenTube

The Dark Side of Prostate Biopsies

Dr. Chovanec

32,805 views

Prostate biopsy can be lifesaving — but men deserve to understand the risks before the needle goes in.

✅ FREE CHECKLIST — 5 Questions to Ask Before Prostate Biopsy
https://drchovanec.kit.com/30968ddb5c

📘 PSA GUIDE — Understand Your PSA Before Biopsy
https://chovano.gumroad.com/l/luikhi

In this video, I respond to the fears many men shared after my previous video on the prostate biopsy trap: sepsis, infection, pain, bleeding, sexual side effects, anxiety, and the fear that biopsy could spread prostate cancer.

We look at what the evidence actually says about:
• transrectal vs transperineal biopsy
• infection and sepsis risk
• blood in urine and semen
• erectile dysfunction after biopsy
• needle-tract seeding and circulating tumor cells
• why informed consent is often too short
• financial incentives in the US biopsy system

This video is not anti-biopsy and not anti-urologist. A prostate biopsy can be necessary and can save lives. But men deserve clear information about the benefits, risks, and alternatives before making the decision.

References / sources discussed:
PREVENT Trial, JAMA Oncology — Transperineal vs Transrectal Prostate Biopsy:
https://jamanetwork.com/journals/jama...

EAU Guidelines on prostate biopsy and infection prevention:
https://uroweb.org/guidelines/prostat...

Needle-tract seeding review:
https://pubmed.ncbi.nlm.nih.gov/24958...

Erectile dysfunction after prostate biopsy — systematic review:
https://pubmed.ncbi.nlm.nih.gov/33026...

Psychological impact of prostate biopsy:
https://ascopubs.org/doi/abs/10.1200/...

Short-term outcomes after prostate biopsy:
https://www.bmj.com/content/344/bmj.d...

Self-referral and prostate pathology billing:
https://www.healthaffairs.org/doi/10....

Disclaimer:
This video is for educational purposes only and does not replace medical advice, diagnosis, or treatment. It is not a recommendation to accept or refuse prostate biopsy. Decisions about PSA testing, MRI, biopsy, antibiotics, and prostate cancer care should always be made with your own doctor, based on your individual risk, symptoms, MRI findings, PSA history, medical conditions, and local availability of biopsy techniques.

Subscribe for calm, evidence-based prostate cancer education.

#ProstateCancer #ProstateBiopsy #BiopsyRisks #BiopsyFear #PSA #MensHealth #Urology #CancerRisk #CancerEducation #DrChovanec

20 Comments

@DrChovanec Creator 2 months ago Pinned

This video came directly from your comments.

Many men told me about sepsis, pain, bleeding, anxiety, sexual side effects, and the fear that biopsy may have made things worse. I did not want to dismiss those fears — but I also did not want to amplify myths.

So this video separates what is real, what is rare, and what every man should ask before prostate biopsy.

Have you had a prostate biopsy? What is one thing you wish someone had explained before the procedure?

✅ Free checklist: 5 Questions to Ask Before Prostate Biopsy
https://drchovanec.kit.com/30968ddb5c

📘 PSA Guide: Understand Your PSA Before Biopsy
https://chovano.gumroad.com/l/luikhi

@scoot77777 2 months ago

I am with you! 20yr Air Force veteran
Desert Storm. When my PSA climbed to 5.1 ... 11-7-2023 the VA immediately wanted to do a trans-rectal Biopsy and remove my prostrate I said let me do some research. I felt very uncomfortable even talking with the VA Doctor! I fought with the VA to see a Urologist out side the VA for two years meanwhile my PSA continued its climb!
Finally got approved to see a Urologist and did the trans-rectal random Biopsy, I asked the Doctor what are the chances of finding anything he said 50/50 I regret doing it He also wanted to remove my prostrate After another year of MRI's & Pet-ct scans you could clearly see my Pirads 5 targets which the random Biopsy missed!
Once I turned 65 it seems the sky opened up ..... I had Medicare A&B and Tricare for life which meant I could chose everything!
The Doctor, hospital and the exact treatment I wanted "NOT WHAT THE DOCTORS SCARE YOU INTO" This year Mar 12-2026 1 got the Trans-perineal Targeted fusion Biopsy and finally found Gleason 3+4=7 one main target and one smaller target. May 19-2026 I chose Nano Knife at Mayo Clinic AZ it seemed to be the best option for my particular situation at the time of treatment my PSA climbed to 20.1.
Just had a recent PSA test it came back 2.9 and still dropping I have a follow up
August 21-2026 with Mayo hoping for another big drop.

@chriscantor6329 2 months ago

As an Australian who has had a transperineal biopsy I am staggered that the USA still use much higher risk transrectal apporaches.

@Malvo6820 2 weeks ago

It seems like after the MRI, they'd rather go to the more expensive treatment instead of giving you a prescription to try and lower your PSA first.

@shamrock8561 2 months ago

I had 2 biopsies under anesthesia. I still feel the first biopsy caused a third lesion. I can’t prove it but I just have a strong feeling that it can cause spread. I had 2 lesions 3+3 and 3+4 very low grade according to my decipher results. 2 years later another lesion showed up . This time it was 4+5. Now I had to get treatment which included

@juliocesarborgesgarcia5925 2 months ago

Sou do Brasil.
A grande questão continua sendo o acompanhamento.
Sempre fazia regularmente e dei uma descuidada de uns três anos.
PSA elevado: 10.8
Próstata normal ao toque.
Ultrassom normal.
Tomei antibióticos e nao abaixou.
Fiz biópsia transperineal.
Acredito que nem a biópsia inicial e nem a ressonância magnética tem condições mostrar o nível real da doença.

Na primeira biópsia foi achado um gleason 6 (3+3)
Como tenho histórico familiar foi indicado prostatectomia radical robótica.
Realizei em Goiânia, dia 28/06.
Resultado da biopsia da peça retirada: gleason 7 (3+4)
Não era somente o que mostrava a anterior.
Uma margem pouco comprometida.
Sem invasão angiolinfatica, sem extensão extraprostatica e retirado os linfonodos que se mostraram livres.
Sigo no estadiamento do PSA que farei em Setembro confiante que estará indetectavel.
Recuperação ótima.
Pouco escape de urina
Preservação total dos nervos, e tendo ereções firmes com o uso de tadalafila apesar se somente poder ter relações sexuais após 60 dias da cirurgia.
Hoje estou com 26 dias de operado.

@cflqin 2 months ago

biopsy will keep PSA higher and higher as it put more stress on prostate. As the results, Dr. will request next biopsy in 6 months if the first one is negative. This is the biopsy trap.

@davidcox-f6d 2 months ago

I have incurable advanced prostate cancer diagnosed nearly 3years ago the biopsy was the most horrendous thing I’ve ever had done to me

@jamesbutcher9743 2 months ago

2017 had trans rectal biopsy- couldn’t pee after the procedure and then had a catheter fitted. I was passing blood and I requested antibiotics as i was worried about infection. Refused antibiotics and subsequently spent over a week in hospital with sepsis. RRP followed a few months later. The whole biopsy episode is barbaric. RRP no issues.

@steinervision7643 2 months ago

I would never get a biopsy! If I needed further evaluation , I would get an MRI, period. I get the prostate exam with PSA yearly, and I am very proactive with lifestyle and diet and supplements. At 72, I feel vert lucky.

@hawaiianfilter 2 months ago

You videos are amazing.. everything you talk about is labeled misinformation, but is very real. Thanks for explaining each of them.😊

@MrMartinRome 2 months ago

Would prostate cancer still be rated as the most common cancer if we stopped calling Gleason 6 cancer?

@mikebell.3286 2 months ago

Thank you great information

@retiredfruitcake 2 months ago

i had biopsie
this bloke is more scary then the thing itself my god...

@whoisjohngalt-hg5us 2 months ago

I had an MRI but the urologist was almost indignant when I questioned his almost flippant response to my concern about biopsy. Oh it's less than 1 in a 1000 and he books patients every 10 minutes clearly demonstrating his lack of interest in counselling his patients. My MRI was apparently fine but there are no guarantees in life.

@robwells230 2 months ago (edited)

Thank you for this valuable video

You are indeed a rare doctor who believes in full disclosure and who listens to patients.
I wish I had had you for my doctor.

My mpMRI with contrast showed locally advanced, no seminal vesicles or lymph nodes involved, PIRAD 5.

I don't think my 15 core TR BIOPSY that showed Gleason 3 plus 3 percent Gleason 4 had any impact on my treatment path, and probably could have, and should have been avoided.

But, to be honest, unlike other parts of my treatment, my biopsy was completely painless with no side effects at all. Easier than getting a tooth filled, but more embarrassing. Some of my acquaintances have not been so lucky.

It seems that cancer treatment is more like a slaughterhouse procedure where we get stampeded down a particular treatment chute like lambs to the slaughter.. one process for all, and when finished, all get shoved out in the same plastic wrapped boxes.

No true shared decision making here in Alberta.

@JustAnother_Irishman 2 months ago

The arrogance in the Irish medical community is extremely concerning right down to the medical secretaries.
Thank you for the info doctor.

@stewartfee1311 2 months ago

I had no blood in stool, or urine. I was surprised as the doctor made it sound as if I would 100 %.

@grateful7839 9 days ago

Had PSMA PET which showed lesion in sector A. Had perineal biopsy, didn’t show anything in sector A (may have missed) but it showed cancer at opposite side of prostate. PSMA Pet showed zero uptake in that area. So in two locations, PSMA PET and biopsy were in disagreement. Urologist’s solution - lets just take the whole prostate by cryo including those nerves. Hmmm.

@GeorgeKennedy-u4r 2 months ago (edited)

Yep, I think that bad urologist I had was "churning" like the old stock brokers used to do. He is associated with the same hospital facility that did the pathology following his biopsy. A clue to me should have been that he refused to facilitate sending the samples out for second opinion as I requested.