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I'm worried

I'm 50 years old and my urinary flow has decreased over the past years. Honestly, I've had less "water pressure" than most guys for at least 15 years, but, in the last three years or so, it's become more noticable. Years ago, I'd say I my flow was 20% to 30% less than my friends. (A guy notices things like that). Now, it's maybe 40% less from normal. In the hours after sex, it's maybe 60% less than normal.

I don't have any pain. I don't wake up overnight to urinate, unless I drink a large amount of fluids just before bedtime. And, in that case, it's only one trip to the bathroom.

I told this to my regular doctor and she had me take a PSA test. It came back 4.4. She insists that I see a urologist, since prostate cancer is a possibility.

But if the urologist does find that my prostate has cancer, I wouldn't want to know. Prostate cancer surgery could leave me impotent and peeing in my pants for the rest of my life. I'd rather live my remaining years without knowing about the cancer, and maintaining my bodily functions.

If the diagnoses is BPH, then that's a chronic condition and benign. Maybe, I should start taking saw palmetto now, just to be safe.

I just can't see any reason to go to a urologist.

Can you offer any advice?
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233190 tn?1278549801
MEDICAL PROFESSIONAL
I would advise seeing a urologist.  If indeed prostate cancer is present, there are ways other than surgery to treat this - for instance, radiotherapy or seed implantation.  Impotence and incontinence are indeed side effects of surgery, but depending the patient and surgeon, the chances can be relatively minor.  

BPH can also lead to the scenario you have described.  To ensure that cancer isn't present, a biopsy would have to be performed.

These questions should be discussed with your personal physician - and I definitely recommend the urology referral.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
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