hmmmmm.......
I would not presume to say that a TRUS biopsy should not be the next step. However, a template biopsy could be of 50 or so needles using a grid so that a tumour has to be very small not to be hit using this procedure. A TRUS biopsy on the other hand is usually of only 8-12 needles. You have to question the logic that if circa 50 needles are unlikely to find it, why possibly 12 at random (urologist says he has nothing to aim for), would stand a better chance! It could be that there is a reluctance to do the template procedure, which is more expensive and involved than the TRUS where there is not much evidence that a man might have PCa. I remember one forum member who going back some time had two negative TRUS biopsies before cancer was found by a template one. Everyone is different. Urologists may take a different route in view of their experience or because they follow a protocol of their hospital.
I would not have thought that BPH would result in a sudden increase in the need to urinate but a urinary track infection could. There could also be other explanations, sometimes urgency and frequency can be a result of stress for example, even the thought of an impending biopsy could cause this. But you have to appreciate that we are not doctors so changed symptoms should be taken up with his GP and if he feels it appropriate referred on to his urologist.
As far as anyone knows at presen,t PCa has not been proven.