You are here:

Urology/HUGE PROSTATE?

Advertisement


Question
QUESTION: I'm 74 y/o w/m. A pelvic MRI 3 years ago described my prostate thus: "moderate enlargement of the prostate gland which protrudes into the base of the bladder." Measured 6.4cm superior to inferior by 5.1 cm medial to lateral by 4.2 cm anterior to posterior. Multiplying those I get 137 cubic cm and multiplying that by 1.83 I get 250.71 cubic cm. My symptoms are moderate -- mainly weak stream, feeling of incomplete emptying, urgency sometimes. Seldom have to get up at night. Is my math mistaken? The dimensions make it sound HUGE, not MODERATE. I've forgotten the details, but I believe a doctor told me to multiply by .49 instead of 1.83.  Thank you

ANSWER: Tom:

The formula for volume of an ellipsoid is height x width x length x pi/6.  In your case this comes out to about 72 grams which seems about right.  Your symptoms suggest the need for treatment such as an alpha blocker like tamsulosin and/or a 5ARI med to shrink the prostate and limit future growth such as finasteride.  Talk to your physician about this.  There is no need to suffer from perfectly treatable urinary symptoms.

---------- FOLLOW-UP ----------

QUESTION: Thanks so much for that formula, Dr Leslie! Regarding shrinking the prostate, I've just started 12.5 mg per day of 1% testosterone gel for symptoms of low T -- 234 total, 44 free. There's no lower dose. It's to treat complete loss of strength and spirit and total daily exhaustion...not for libido. I read Dr Morgentaler's book "Testosterone for Life" and expect the therapy might even increase the prostate size a bit, though it's a very low dose. The question then: Is it possible to shrink the prostate a bit with a 5ARI med while simultaneously boosting the testosterone to improve quality of life? Sounds counterintuitive, of course. If one must make an absolute choice, overall quality of life trumps urinary difficulties (I think).

Answer
Tom:

Taking extra testosterone at age 74 does run the risk of exacerbating prostate enlargement, urinary symptoms and even prostate cancer.  However, since the finasteride works only inside the prostate cells, it is possible to take both together.  You can also take the tamsulosin either way since it has no direct effect on testosterone.

Urology

All Answers


Answers by Expert:


Ask Experts

Volunteer


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

©2016 About.com. All rights reserved.