35yo at Mayo Clinic - what's next?

Hi folks,

I'm a 35yo man doing active workup at Mayo Clinic for the symptoms below. The following labs were found and the current thinking from the PA in Uro is that it's prostatitis. Due to my age she feels that PCa is extremely unlikely and is advising against further diagnostics. She's not opposed to it, however, so I'm looking for advice. I've read about more specific tests (PCA3 and PHI, not sure if they're the same?), cystoscopy, T3 MRI, and biopsy.

Symptoms:

• Fever ~100 - 6mos
  
• Pain on ejaculation - 3 mos
  
• Pain in supra-pelvis, middle/right - 2 mos
  
• Incomplete voiding, requires tightening/push - 4 mos

Findings:

• Microhematuria - 3x on UA/scope over the last 2 months
  
• PSA - 1.1 (ref range 0-2 ng/mL)
  
• Prostate secretions negative incl ureaplasma and myco bacteria
  
• Amorphous crystals detected
  
• CT w/ contrast was unremarkable

So the question: what should I ask for next, if anything? If action is advised, in what order? If no action is advised, should I ask for retest of PSA in the future? Thanks!!

PHI is a blood test, as is 4K Score. PCA3 is a urine test after a vigorous DRE.

But, you are getting WAY ahead of yourself. The odds are overwhelming that you have prostatitis.

That usually comes and goes on its own, not responding to antibiotics in most cases, just the passage of time.

With your low psa, there is no reason to think that you need more tests at this time.

Thanks gents! She said that my PSA was high for my age, hence the questions. Infection was ruled out this weekend with a prostate excretion urine test (lab above) that was negative. We review treatment plan tomorrow so wanted to be prepared. She mentioned antibiotics for bacterial but only epsom salt bath for non-bacterial prostatitis. I plan to push for antibiotics anyways and wasn't sure whether I should ask for a scope or more tests based on the comment about my elev PSA. 3 unanimous opinions are enough for me - thank you!!

I dealt with prostatitis on and off for about 35 years. Tried several types of antibiotics. Negative Cystoscopies. Best relief was Sitz baths until Green Light procedure for BPH in 2009.