Prior biopsy history (OR: 3.148; P = 0.021) and inadequate biopsy experience (OR: 0.701; P = 0.032) were associated with a GS of 10 upgrading on contra-SB + TB (Table 5).The basic characteristics of the only patient with significant upgrading on contra-SB + TB were as follows: age 82 years, PSA 30.24 ng/mL, DRE ( +), TRUS prostate volume 66.9 mL, prior biopsy history, abnormal TRUS findings, urologists’ biopsy experience 5, MRI suspicious lesions 1, maximum PI-RADS 5, and lesion position PZ. The gene discussed is KLK3; the disease is tuberculosis.