I am a 57 year old sexually active male in excellent health. Drink alcohol pretty much every day, sometimes one drink or glass of wine, sometimes 3-4. PSA history: 9/01 2.48, 7/04 3.99, 6/05 2.63, 12/06 3.2, 9/07 3.1, 12/07 3.7, referred to Urologist by PCP. Off and on symptoms of testicular discomfort for years. Said symptons worsened at this time with the addition of discomfort at tip of penis and less than spectacular ejaculation. No other symptoms. Saw Uro 1/17 DRE neg, urine neg. Had bladder and kidney sono done, neg. Returned to Uro 3/11, dre neg, prostate warm and boggy, recommended biopsy, took blood for total psa which was 4.7. I stated that my symptoms appear to be prostatitis. He did a quick massage. Put me on Levaquin for 21 days. Not much if any improvement of symptoms. 4/21 another 21 days of Levaquin. 5/20 psa 3.7 symptoms much less severe but still exist. Uro insists on biopsy. 5/29 psa 3.54.
I obviously want to avoid an invasive biopsy if possible. I feel my Uro is pushing the biopsy, almost from day 1, and is not interested in going further with other blood, urine or prostatic fluid testing, massage therapy etc. Uro refused to do free psa or any other kinds of testing for prostatitis. I am inclined to go see another uro who might be more progressive in that area. Psa is trending down. What would you recommend I do?
As regards your numbers, they are borderline concerning. The definition of normal values are in flux. Trends and speed of change are important considerations and some of your changing values do make me concerned. Your psa's are all over the place, which does happen in some men. A recent orgasm, urinary tract infection/bacterial prostatitis, recent prostatic massage/exam and prostate cancer can raise your psa. I suggest that all psa's be done after three days without an orgasm and either immediately following a rectal exam or three days later. A percent free psa is reasonable as is a second opinion. You need to be comfortable with you physician and have confidence in that individual's decisions.
This information is provided for general medical educational purposes only. It
does not necessarily reflect the opinions of Henry Ford Hospital or the
Vattikuti Urologic Institute. Please consult your physician for diagnostic
and treatment options pertaining to your specific medical condition
Copyright 1994-2018MedHelp.All rights reserved. MedHelp is a division of Vitals Consumer Services, LLC.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.