The diagnostic value of prostate specific antigen (PSA) change after receiving antibiotic therapy due to prostate specific antigen (PSA) elevation and prostate cognitive fusion biopsy with multiparametric prostate magnetic resonance imaging (MRI) in detecting prostate cancer

OBJECTIVE: An answer was searched by detecting the incidence of prostate cancer with cog-Bx in patients who had a PSA decreasing after antibiotic usage to the question that "Can we avoid unnecessary prostate biopsy in patients with decreased PSA values?". METHODS: The data of 206 patients who applied to Bezmialem Vakıf University urology outpatient clinic between January 2017 and January 2018 and who had a cognitive fusion prostate biopsy to 129 patients by detecting suspected mpMRG findings (PI-RADs III,IV,V) and who had standard 12 quadrant TRUS-Bx to 77 patients by detecting PIRADs I,II or no mpMRG after antibiotherapy (ciprofloxacin 500mg 2x1, p.o, 4 weeks) due to increased PSA, regardless of PSA decrease were examinated. RESULTS: The mean age of the 206 patients who participated in the study was 62.97 ± 7.68 (44-84 years). In the 129 patient who has mpMRI imaging, 34.1% of the patients underwent PI-RADs I-II, 22.5% of the PI-RADs III, and 43.4% of the PI-RADs IV-V lesions. A significant correlation was found between PI-RADs score, PSA density, suspected rectal examination and prostate cancer (p:0.008, p:0.001, p:0.001), and between PSA density, suspected DRE finding, and clinically significant PKa (p:0.005, p:0.028). According to PI-RADs groups, it was found that PSA change after antibiotherapy had no effect on the diagnosis of PKa (p>0.05). CONCLUSION: There is no difference between PI-RADs groups and PSA change after antibiotherapy in terms of diagnosis of PKa. Prostate biopsy should be performed in patients with high PSA without antibiotherapy regardless of PI-RADs score.