Asymmetric Prostate - significance ?

[Peterz]

At 53, I had my second DRE today, with the doctor noting the my prostate was asymmetric (one lobe 50% larger than the other, and smooth.  He did not use the word nodule.   PSA testing is under way.   I don't seem to have any symptoms of prostatitis, although the doctor did not talk about that as a possible cause.  Last year his  PA did the first DRE and did not find anything odd. Should I be doing other things like sonograms, a biopsy, etc. or wait until the PSA results come in?   And if PSA resulst are elevated, what would be a normal course of actions?

Thanks.........

[Ash Tewari, MD, M.Ch.]

An asymmetric prostate is quite common. Another consideration is BPH (benign prostatic hyperplasia), a UTI, or prostatitis. It is important PSA testing is not done after a DRE or sexual activity as this can cause serum PSA levels to rise.

If this is your first elevated PSA level, the normal course of action would be to repeat PSA testing again.

Best,

Ashutosh K. Tewari, MD

[Ash Tewari, MD, M.Ch.]

Hi Peterz,

Your PSA sounds very reassuring, especially as the free PSA is 22%. Your PSA is not raised, so the chance of you having prostate cancer is not high.

Taking a course of antibiotics for possible prostatitis is a very good option to pursue. Prostatitis may indeed affect only one lobe.

Noentheless, the only way to be sure what's going on in the prostate is to go for a  biopsy. If you have never had one, you might wish to have one done for your reassurance as a basline to reference future PSA trends against.

Sincerely,

Dr Ash Tewari, MD

[Peterz]

Thanks.   My PSA results (before DRE and no sex): 1.02 with free PSA of 22%.  Urine sample was OK (but don't know if would be used to help diagnos prostatits or was just a standar thing a urologost looks at).  During my first DRE, 1 year ago by the physician's assistant, no abnormality was noted.  Could prostatitis cause swelling in one lobe of the prostate?  And given my apparently normal PSA, should I talk to the doctor about going on antibiotics then doing another DRE before the biopsy which the Dr suggested.