My PSA is up and the biopsy is positive. Do I need surgery now?

Often not immediately. Low-risk, low-volume disease is frequently managed with active surveillance — regular PSA, MRI and repeat biopsy — with the option to treat if it progresses. Higher-grade disease is different. The grade group in your report is the key line.

What are the real chances of incontinence or impotence?

They depend on your nerve-sparing anatomy, age, baseline function and the surgeon's volume. Published averages are wide. Ask your surgeon for their own figures at twelve months — a good surgeon will have them.

Is robotic surgery better for the prostate?

Robotic surgery reduces blood loss and hospital stay. Cancer control and continence outcomes track the surgeon's experience more than the platform. An experienced open surgeon can beat a low-volume robotic one.

Do all kidney stones need an operation?

No. Many small stones pass with fluids, pain relief and time. Intervention is for stones that obstruct, cause infection, or are too large to pass. A blocked, infected kidney is an emergency, not a waiting matter.

Urology

Prostate decisions especially reward a second reader

Surveillance, radiation and surgery can all be correct for the same PSA and biopsy. What differs is your risk group, your age and what side effects you are willing to accept. A verdict lays out all three paths.

Operations we review in this specialty

Radical prostatectomy vs radiation vs surveillance
Partial or radical nephrectomy
Stone surgery and ureteroscopy
Bladder tumour resection
Reconstructive and obstructive procedures

30%

of prostate reviews raise surveillance as a valid path

Submit a urology case

Meet your reviewers

Specialists reviewing urology cases

You can request a preferred reviewer when you submit — your coordinator confirms availability before the service-level clock starts.

Dr. V. Krishnan

MCh Urology

Urology 19 yrs in practice

Uro-oncologist and stone-disease specialist reviewing prostate, kidney and bladder surgery proposals.

View profile & request this reviewer

Watch first

What patients ask us most — answered by the panel

Short vertical answers from specialists who perform these operations. Read the written answer, or press play.

Panel answer
My PSA is up and the biopsy is positive. Do I need surgery now?
Video answer filming soon
Dr. K. Verma
Urologic surgeon · 17 yrs · robotic prostate
Often not immediately. Low-risk, low-volume disease is frequently managed with active surveillance — regular PSA, MRI and repeat biopsy — with the option to treat if it progresses. Higher-grade disease is different. The grade group in your report is the key line.
Panel answer
What are the real chances of incontinence or impotence?
Video answer filming soon
Dr. K. Verma
Urologic surgeon · 17 yrs · robotic prostate
They depend on your nerve-sparing anatomy, age, baseline function and the surgeon's volume. Published averages are wide. Ask your surgeon for their own figures at twelve months — a good surgeon will have them.
Panel answer
Is robotic surgery better for the prostate?
Video answer filming soon
Dr. K. Verma
Urologic surgeon · 17 yrs · robotic prostate
Robotic surgery reduces blood loss and hospital stay. Cancer control and continence outcomes track the surgeon's experience more than the platform. An experienced open surgeon can beat a low-volume robotic one.
Panel answer
Do all kidney stones need an operation?
Video answer filming soon
Dr. K. Verma
Urologic surgeon · 17 yrs · robotic prostate
No. Many small stones pass with fluids, pain relief and time. Intervention is for stones that obstruct, cause infection, or are too large to pass. A blocked, infected kidney is an emergency, not a waiting matter.

The decisions a verdict actually settles

Active surveillance is a real option

For low-risk prostate cancer, structured monitoring has excellent long-term outcomes and avoids incontinence and erectile dysfunction. It requires discipline, not courage.

Save the kidney where possible

Partial nephrectomy preserves function for many small tumours. Whether it is feasible depends on tumour position and the surgeon's comfort.

Side effects are part of the decision

Continence and sexual function outcomes vary between surgeons and centres. Numbers, not reassurance, should inform your consent.

Is it safe to ask?

Yes — and here is why

Bring your grade group and MRI

Prostate decisions hinge on the specifics. Grade group, core involvement and PI-RADS score let a reviewer be precise rather than general.

Slow disease, real time

Most prostate cancer grows slowly enough that a considered decision beats a fast one.

Your fee is held, not spent

Payment sits in escrow until a quality-checked verdict reaches you, and a service credit applies automatically if we miss the clock.

Do not wait for a review

Seek emergency care now if you have

Fever with flank pain — possible infected obstruction
Inability to pass urine at all
Visible blood in urine with clots
New severe back pain with known prostate cancer

A second opinion is for planned decisions. It is never a substitute for urgent treatment.

Before you submit

Records your reviewer will want

Complete records are the difference between a 48-hour verdict and a week of chasing. Bring what you can — our coordinator tells you what is missing before the clock starts.

PSA history with dates
Prostate MRI images and PI-RADS report
Biopsy report with grade group and core details
Urology consultation notes and proposed plan
Kidney function and imaging of the urinary tract

Other specialties

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