Prostate or Hernia or Colon?

[oldmama]

My husband has had pain in his lower groin area for about a year.  I finally got him to a doctor.  The only thing it showed was that his PSA was around seven.  He was told to have it tested again after we moved.  Five mths later he finally got it tested again.  PSA was 8.8 .   The doctor sent him to a urologist.  Urologist wants to do a colon test and a biopsy on the prostate.
Well that scared him so he went to another doctor and that doctor said that the PSA (8.8) was not high and that he thought he had a hernia.  (My husband is prone to lifting heavy items all the time and has had a hernia about ten years ago.)  He also has had a blockage in his penis about fourteen years ago so he doesn't shoot out sperm anymore.  Also, for the last year he has not been able to have sex.  A couple of weeks ago we tried the little white pill with high hopes that he would be able to get it up.  The four hour pill lasted one minute. Disappointed to say the least. We really need some help here.  He has no insurance and if we keep all the appointments we will be in deep money problems.  Where should we start, with the hernia? or prostate? or colon?  

[HeinrikMD]

You're welcome.
I hope your husband is not getting frustrated.
Unfortunately these episodes of yes you have it one day- then no you don't have it next day, are all part of trying to capture disease in the early stages.
Stay positive, my best to you and your husband.

[oldmama]

Well it is back to the drawing board.  He went to the hernia doctor and was told he does not have a hernia.  So now he is waiting just to get an apointment with another U doctor.  Yes, he has had about three DRE's now but it must feel normal for they have not said anything that I am aware of.  His pain is back but while he was on the flo-max he felt better.  Thanks for the come back, and you too dr. Heninrik.

[Artdude]

Having had a robotic prostatectomy this past fall because of a lower PSA that your husband's numbers, I would urge you to check out another urologist if you are uncomfortable with your current physician.  8.8 is NOT low.  It should be of some concern.  My was 6.8--antiobiotics and flo-max brought it down to 2.9 after the summer.  My biopsy showed cancer, and then i had surgery.  High numbers do not automatically indicate cancer, but....  Did your husband not also have a digital rectal exam? What did the urologist discover with the DRE?  Did the physician address prostatitis?  The inability to perform sexally could be many things, but when you add them up you should consider having the prostate checked out further.

[oldmama]

Thank you.  We will go with the hernia part first and see where that leads us.  Appreciate the help.

[HeinrikMD]

Hi,
I think that its best to address the pain and this would likely be the hernia, unless the pain is also related with difficulty voiding - there is such a thing as pain due to nerves that overlap with nerves on the prostate.
The level of the PSA where biopsies are recommended are usual for levels more than 4. The level from 4-10 has its controversies, because there would indeed be a lot of biopsies that are benign. Some patients are asked to do a free PSA, this would help select which patients are best biopsied. Another thing to do is to see how fast the PSA rises in another 6 months or so and then another discussion whether to do or not to do the biopsy is called back to the floor.
Discuss your worries with your doctor and try to come up with a plan that is acceptable to you.
Stay positive.