Generally a urologist will make you wait eight weeks following a biopsy before proceeding with treatment, in order to allow the prostate to heal between procedures.  The actual medical reasoning is something I can only guess.  Like my broken leg, a tibia plateau fracture.  My orthopedic surgeon told me that my knee was "mush" for a couple weeks after the initial injury and he could not operate on it until the fluid was re-absorbed. Presumably the prostate is the same way.  After a biopsy the prostate is swollen as a result of the irritation and would be difficult to treat.  Most everyone I've spoken with says to allow 6-8 weeks for it to settle down.

Jess,

My situation after biopsy was a bit different than what the other guys have described:  NO precautions, for any period of time.  All they told me to do was continue the antibiotics, and be aware of possible signs of infection.  They did not suggest recommending avoiding sex or anything else.

My doctor is part of a group of urologists (about a dozen).  Most are surgeons, a few are not.  And it is part of a teaching hospital. My own surgeon (well over 1,000 prostectomies now, and did Residency at MD Anderson/Houston) told me sex before a PSA test is irrelevant, or so close to irrelevant as to be treated as such.

My G.P. (Ivy-trained in the US, and then medical school in Switzerland) told me the same thing:  I asked if PSA draws after sex the night before would effect outcomes, and he said "absolutly not."

I know that these doctors' responses differ from the conventional wisdom at this site. Some guys even respond with a clinical study or two.  But it seems intuitive to me: Why WOULD sex impact PSA ?  And when is "waiting" going to be "waiting long enough ?"  It's like saying "We can't get a reading on his heart because it's beating" or "we can't study his upper G.I, because he's been swallowing saliva."

I never let sex effect when or how I had any prostate testing done, or when I had sex afterward, and saw no ill effects from such a policy.  As to waiting for an MRI: regarding that, I cannot advise, since I've never had a prostate-related MRI in my life (except to assit in Kegel training); it was never deemed clinically necessary in my case.

Regarding "diet": absolutely nothing in the human diet has clear, unambiguous effects on prostate health, short or long-term.  This is the conclusion of the American Cancer Society and the most authoratative agencies writing on the subject of foods and prostate cancer development or treatment.  Humanity  has sought miracle cures and diet relief since we broke off from Neandethals,and I guess we always will. Reefer is the most popular myth, but it is just that: a myth.  I eat healthy and recommend such to other men, but not becausde of the prostate itself:  Rather, because of other benefits, such as cardiac health and avoiding obesity.  A slim man with a strong heart can better fight PCa than a fat guy with coronaries, but only because a slim guy can better withstand any form of treatment for any illness, regardless of location.  When I was 30 I was run over by a car, crushed in-effect to death.  Two months in the hospital, and then a year of rehab.  My then-G.P. volunteered something to me a few years later, without me asking, during a discussion of me living through that, when most of my medical team said I would not survive:

He said, "Two things saved you. You were not fat, and you were not old.  If you had been either, you would have died."

Again, guys here will differ, and support some dietary study that suggests otherwise. Problem is, ten other studies suggest otherwise, and a food-PCa link has not been proven to the satisfaction of the leading authorities, and they conclude therefore that there is no established food-PSa link.

Vegans, monks, and sausage addicts get PCa at the same rates, with the same prognosis thereafter.

max

My husband had two MRI guided biopsies over the past two years, and the "big one" fall of 2017.   The MRI guided were easier to recover from.  His final biopsy was horrible.  He was uncomfortable for weeks/months.  He developed an infection about three weeks after.  Pain just wouldn't go away.  Started feeling bad, then started running a fever.  He started on antibiotics, and was better within a week.  He has said that he was uncomfortable for months after each biopsy.   So if you are having continual pain, I would get with your doctor. 

His surgeon/oncologist at MSK would not do surgery until he had 12 full weeks to recover from the biopsy.  His biopsy was 10/13, and his surgery was 1/30.  This gave the prostate and surrounding nerves time to heal from the trauma.  As his doctor said, he had one shot to make the surgery successful (nerve sparing), and no need to rush before everythign healed up. 

It seems the MRI should have been done prior to the biopsy.   All of my husbands were done before the biopsy.    I probably wouldn't have an MRI done until at least 12-14 weeks after - for the reasons shown above - time to heal from the trauma. 

Regarding the role of sexual activity and PSA levels, there is a wildcard variable that makes generalizations difficult. Prolactin is a mysterious hormone secreted by the pituitary gland in both men and women, but for diffetent purposes. And it is secreted at different levels among men.

Its purpose in men appears to be shutting down testosterone production and squelching sexual desire immediately after coitus.

If any of you ever watched How I Met Your Mother... though fictional, the Barney character was a classic high prolactin level type... As soon as coitus was over, it was "See you later I'm outahere, I'll call you (not!)" But Howard on Big Bang Theory was the low prolactin type. .. "All night long y'all!" 

Just a light hearted way to illustrate that guys with low prolactin levels will continue to produce testosterone continuously and stay horny all the time but guys with high levels can have their sex drive grind to a screeching halt.

I cant say for sure, but i am wondering, since the androgens in testosterone excite prostate cells, its possible the guys with high prolactin  levels will register no significant changes in their PSA levels after sex, but guys with low prolactin levels may be producing testosterone and androgens long after sexual activity and increased PSA levels. Not sure I can say that for sure, but it would account for the wide variation in opinion among urologists.

Here's a look into this bizarre hormone from the point of view of a male fetility site...

"Some hormones just don't tend to play well with your testosterone.  Cortisol and estrogen are examples.  Another hormone that can whack your testosterone and your sex life is prolactin. Prolactin is a fine hormone and great for sleep, but, unfortunately, it makes a lot of other important things go to sleep, including your testosterone and fertility if levels are high enough. It is, not too surprisingly, often devasting to erections due to decreased testosterone levels and because it antagonizes dopamine and leads to an increased refractory (recovery post-erection) period. [4]  Excessive prolactin is also associated with gynecomastia, i.e. "male boobs". [2] And probaby most dangerous of all in the long term, prolactin is probably an inflammatory cytokine (TNF alpha, IL-6, etc.) and has been linked to various inflammatory diseases, especially lupus. [7]"

That rascal hormone prolactin is what makes men want to turn over and go to sleep after sex, even when their  partner is a supermodel and wants multiple *******.  Extremely high prolactin levels are being looked at as a cause for ED now as well. And have you ever known guys who don't date and never seemed interested in a sexual relationship?... Everybody thinks "Low T levels" when it might be caused by high prolactin levels.

Dont know if it does account for the wide variation among men and their PSA levels after sex, but dont know if it doesn't, either.