Urology/Psa

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Question
I am 57 years. A few months ago I started having a slight pain in right groin. I went to a surgeon who said I had hernia and needed surgery. At the same time I was feeling a burning sensation while urinating. Lately the burning is felt after urination and lasts for hours. I took a ct scan with contrast . This was clear as was a srotum ultrasound.
A lumbar xray showed severe denigration of L1/L3 and l4/5.
At this time  I took my annual Psa. I was shocked to see it had jumped from 1.2 to 7.1 in 12 months (previous 11 years it has been less than 1.5). A second psa 4 days later jumped to 24.1. The urologist said it was unlikely that I had prostrate cancer. The psa elevation was caused by inflammation of the prostrate. I have been on Cipro 500 mg x 2 for 3 weeks. I still feel a slight burning. I have to take the psa again next week. I am very concerned and anxious that this is very serious.
Do you think my problem is the inflammation  and if so can this burning and discomfort  in the groin be cured ?Thank you

Answer
Rick:

I agree with your urologist that prostatitis or prostatic inflammation is far more likely than prostate cancer based on your presenting symptoms.  The groin problem is probably the hernia.

Typical treatments for prostatitis can take 6 weeks or longer so your situation is not unique.

Summary of Typical Treatments for Prostatitis:

Avoid caffeine, high potassium foods and hot spices which irritate the prostate and bladder.
Hot sitz baths.  Sitting in a very hot tub for 10 minutes really seems to significantly reduce pelvic pain, inflammation and discomfort.  We recommend twice or even three times a day for severe cases or flare-ups, but at least once a day for most prostatitis patients.  Of all the remedies listed here, this is the one with the greatest effect on overall improvement of prostatitis symptoms.
Avoid sitting on hard surface; use an inflatable donut (filled only half way) to divert the pressure away from the prostate towards the pelvic bones where it belongs.  You may also use a gel sitting pad similar to what is used for patients in wheelchairs to minimize pressure on the lower pelvis.
Use NSAIDs like ibuprofen (Motrin, Advil) or naprosyn (Aleve) regularly on a daily basis, unless instructed otherwise by your physician, to help reduce pelvic discomfort and inflammation.
Take the antibiotics as prescribed by your physician.  Typically, at least 4-6 weeks minimum is required.
Alpha blocker medications such as tamsulosin (Flomax) and alfuzosin (Uroxatral) will help relax muscle tension in the prostate, promote healing and improve urinary flow.
Reduce alcohol intake and stop smoking.
Consider using a prostate herbal product that contains Quercetin (found in many prostate supplements like Prosta-Q and Cysta-Q available on Amazon or directly from Farr Labs at www.farrlabs.com) which is a natural anti-inflammatory herbal ingredient that has actually been shown in independent tests to help reduce inflammation in the prostate.  The highest rated combination product according to the “Prostate Health Journal” was “Prostanew” from BioProsper Labs in Indiana which can also be ordered on Amazon.

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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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