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Urology/prostatatitis,

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Question
Dear Sir,

I am sorry to be once again asking you as my Urologist,seeing slight bulk on Seminal Vesicles in Transrectal sonography,informed that slight inflammation exits,which may indicate wrong PSA.
He continued Silodosin-8mg and Dutasteride-0.5mg(once/day) with Doxy-100mg/twice a day for 21days.He also asked to sit in hot water bath tub for half an hour everyday.
This may subside the mild inflammation and on 25th PSA and Urometry will be repeated.
I kept your advice in mind and would follow the treatment as there is no other symptoms like fever etc.However may I ask you couple of question:what is next if PSA is not 4.Whether this value is absolutely required to be achieved? though i agree to monitor twice/year.
I would prefer to go for Surgery when it is called for and then biopsy can be done.What is your comment?as I understand if PSA being tumour marker,what are the chances of cancer if exceeds 10 and what value is more on less indication to go for surgery.
Sir,I have no problem in Urination and with medication if Prostate is contracted what will be benefit?
Whether such inflammation may reoccur?and what will be the test as
I being a patient is now on like assembly line to go for treatment  and tests for rest on the life,without any significant trouble.
I am sorry for my such feelings but you would appreciate the repeated visits and expenditure in retired life.
Hope you would guide me with your valued experience in the field.
I am really thankful for your support.
With warm regards in NEW YEAR
agdesai

Answer
Anil

I'm not going to speculate on what may or may not happen or what to do with any particular PSA.

There is no role for surgery prior to a biopsy.  If the biopsy shows only inflammation, then you've had an unnecessary surgery.

There is no absolute number of PSA that indicates a cancer.  I've seen PSAs that were in the hundreds with no cancer and severe prostate cancer with very low PSA levels.  It is a general indicator only and we cannot use it to decide on doing a surgery although we can use it to decide if it's worth doing a biopsy.

Medication would be used to help completely heal the prostatitis and to prevent recurrences which you've had.

There is a high risk that a repeat bout of prostatitis may occur.  This is why the treatment period is relatively long.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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