Posted 9/13/2020 1:12 PM (GMT -6)
Before my TURP, my uro/surgron explained that some men will need a second procedure of some kind after a TURP, because the prostate does not stop growing from BPH after a TURP. My numbers above show that in the 3 years between my TURP and RP, my prostate had grown back about 50% of the amount of tissue removed. I think the rate of growth varies considerably man to man -- many men, probably most, do not require further treatment. Your dad's uro is best suited to estimate your dad's prognosis in various scenarios.
Unfortunately, diagnosing PCa when there may be multiple sources of increasing PSA may be as much of an art as a science. This is where a uro's years of experience really count. My hunch is that your uro will take your dad's post-TURP stats as a new baseline for monitoring him with regard to prostrate size and consistency; PSA value, density, and rate of climb; and any symptoms of prostatitis and/or BPH. There are other tests that may be of value for predicting PCa, like the PHI.
Based on my experience, when you have a uro you trust, and he or she suggests it's time for a biopsy, agree to it! And if you don't trust your uro, it's time to find a new one. In my case, the sheer number of repeat biopsies I had makes it very likely I did not have PCa along with my BPH for many years -- until I did! PCa can form at any time. In the majority of cases it is low-grade, but about 15-20% of the time it is clinically significant cancer that you want to diagnose as early as possible before it metastasizes.