New here a few questions

I hope his is not too long but I guess some context is needed. I have had prostate issues for a long time that
I was always told was either "it's inflamed" or BPH.(DRE) Symptoms, night bathroom visits, dribbling, feeling that tight pressure like your sitting on something. As you can see below the last PSA was startling.

I had been on flowmax for a while, about 3 mo ago I wanted to see how I would do without it.
Seemed not to bad at first, but about 3 weeks ago things started getting worse. (had been maybe drinking too much coffee also) but more noticeable of the slow start urination, some burning both in the prostate area and some in penis after words. Then when sitting sometimes what felt like discharge but I would only have 1 clear drop come out. Started back on flowmax things improved again some. However I noticed a soreness in the rectum area which
I never had as a symptom before. Was scoped yesterday and he said he was not seeing anything to cause that and that my prostate was big but he could feel nothing hard. Suspects the pressure from the enlargement is causing the soreness. He seemed a bit alarmed by the last PSA and ordered a ct scan with contrast of the abdominal and pelvic area, which is the 30th. I see the urologist on the 3rd.

On that last PSA I am pretty sure I was sexually active within 48 hours of that as I had no clue that could matter until I was reading after the fact. Also I have a history of prostatitis but it had been a while. I also know that with flowmax
your ejaculation tends to be internal. I am wondering how much that could have effected this test? Also I have read
that prostatitis can dramatically increase that score. My GP has me on cipro which I started yesterday he then wanted to check the PSA again after that's done. Last question, if you had slow start urination as in waiting as you feel it working to get out and if that was due to an abnormal growth rather than an enlargement, wouldn't that restriction be the same flowmax or not? Seems maybe there would be a difference between a physical obstruction and normal enlargement? Pretty scared right now because I see from these posts how definitive PSA seems to be
but such a large jump on something they were saying you should have checked once a year seems odd?



59yr
7/13 PSA 2.34
5/14 PSA 2.02
9/18 PSA 1.88
9/19 PSA 6.18

JOhn,

Getting to a good Uro is a good first step. It's doubtful that big a jump in a year is from cancer--cancer is usually about slow steady rises. Keep us in the loop about what is happening...

Welcome to HW.

prostatitis and BPH could explain the PSA jump and your symptoms. PSA due to PC tends to rise slower and not do big jumps. It's good that you're getting a scan and seeing a URO. Do let us know what you find out.

Prostatitis tends to be difficult to diagnose and treat - often just comes and goes on its own. You might need more BPH meds or possibly a TURP procedure, all things that your URO will likely discuss.

Since you're posting on a PC site, I'll assume you're worried about that. Well, at your PSA number, PC would normally have no symptoms. PC tends not to have symptoms until later stages. The only way to know is to have a biopsy - your URO will let you know what he thinks. In most cases you don't move to that until all other causes have been ruled out and since you've had prostatitis and BPH, the doc will most likely recommend treatment based on that.

You do have something that needs to be looked at.

Keep us updated,
Andrew

That's a pretty big jump in Psa, which likely is due to an infection, (based on your symptoms). Infections can make Psa numbers go crazy. Your Uro seems adequately cautious, (a good thing) but I question why the CT scans are needed before an infection is ruled out with the cipro. It's unlikely anything would show up with your low numbers in any case.

John 88, don't need to scare you but my psa in 2014 was 3.8 in 2016 it was 19 and if you read my signature you can see how it turned out. As I tell all the new guys find a good team of doctors become your own advocate and then proceed hopefully it will just be a short term issue!!

Larry

You already got some great responses, so I'll just chime in and say welcome. Good luck as you work through whatever this is...

Did he order a scan with contrast or a mri with contrast? A scan does not make sense to me with your current parameters, it is mainly aimed to look for metastasis or kidney stones, but I am not a medical professional so that I may be wrong.

At the least the scan should be able to give a size on the prostate. That can help confirm a BPH DX also there might be something else going on not related to the prostate.

In any case the additional tests are prudent - even if they only rule out possible causes, it gets you closer to what's causing your problems.

Update, I had the CT scan done 9/30 I was told by my Gen/Vasc Surgeon that the only thing it showed was
two calcification spots in the prostate. (Left side) I had been on the cipro for 7.5 days but had to stop as it was making my peripheral nephropathy in my feet worse. That's something I have had to one degree or another since 2015 or so, I know my back plays some role in that.

The Uro, DRE said it was normal, but not sure what he means by normal because the psa change from 1.8 to 6.1 indicates a change. But I think he takes the BPH part as given, I know I had some symptom improvement on the cipro and it may be I was on it long enough that when I saw him there was some change at the time of the DRE.

His plan was for a PSA retest in 3 mo, saying it takes that long for things to calm down and your level to drop.
Not sure if I should wait that long, was thinking see my GP for another test at the end of the month? Tough choice because if it has not dropped that may prompt panic yet according to the uro there may be a reason hence 3mo.

What concerns me the most is this sorness, left side of rectum and I can push on the left side outside the rectum just up under the pelvic bone and it's sore. I don't know if that's my prostate or something else. I know a CT scan is not optimal for viewing the prostate directly but I would think it would have shown some kind of abnormality if it was something advanced considering the contrast. Could that calcification be playing a role in that? From what I read that seems to make you prone to prostatitis also but it's only sore on one side.(the same side) For the record I have hernia mesh both sides from the 90's not sure if that can play a role or not.

59yr
7/13 PSA 2.34
5/14 PSA 2.02
9/18 PSA 1.88
9/19 PSA 6.18