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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3593
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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I have a question about Urination. I am a 50 y/o white male.

Resolved Question:

I have a question about Urination. I am a 50 y/o white male. I am otherwise good health. My urination patterns are as follows:

1. Normally I have no problem starting and I go straight through with a minor push occasionally. I shut off normally with a few last squirts and small drops.
2. I do not dribble when I start (unless its the situation I describe in point 3)
3. I notice that I do start slow when I have been been holding it in ( when in the car and cant stop) and then it picks up speed
4. I am a very anxious person and sometimes I am peeing all the time and sometimes less
5. When I drink coffee ( 4 cups in the am) I find it makes me pee slower and water (and like liquids) makes me pee faster and stronger
6.I get a tingling sensation at times in my anus area and after I pee sometimes an dull ache at the tip of my penis and in the penis shaft ( straight male, no anal intercourse or the like)
7. I have noticed a bit of an ache at times in my pelvic area
8. and now for the kicker I have a PSA of 5.5. My doc did the DRE (normal) and he flt my prostate felt "baggy" suggesting prostatitis

Thats it...my urination patters have been the same for years and now that I have this elevated PSA I am trying to decide of I have been ignoring "urination problems" for years or this is me and how I pee.

Please help..thank you.
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Tharun replied 1 year ago.
HI

How are your bowel movements ?

Do you have any back problems ?

Is this the only PSA value you have ?

Do you have pain while ejaculation?

How are your erections ?

Any pain in the testicles?

Do you travel a lot?

Exposure to hot climates ?

Please let me know

Dr.Tharun
Customer: replied 1 year ago.

Good - very regular


None other than lifelong pack pain


Yes


None - no blood in semen


Good ( anxiety makes it more challenging)


Just an occasional ache


Yes


Not really


 


and I am 51 not 50 *(tying to fast)


 

Customer: replied 1 year ago.
Relist: Other.
I am not sure if this is beyond his comfort level given the time to answer?
Expert:  Dr. Tharun replied 1 year ago.
Hi

Sorry for the delay.

The urination is mostly normal for your age.There is always some delay in starting after holding it back for some time.

Single PSA value is never taken as a final one.It is repeated and if it still remains high, we have to analyze it further.

There could be many reasons for elevated PSA like prostate enlargement, infection, cancer etc.

So interpretation has to be done on at least 2 PSA values.The next PSA value should also include FREE PSA to TOTAL PSA ratio.This ratio can determine whether there are high or low chances of bearing a cancer for a given PSA level.

Regarding prostatitis you definitely have some of its symptoms like pain around the anal region, penile pain etc.It is a difficult condition to treat with a single medication.Usually a combination of medications like alpha blockers, muscle relaxants, hormone treatments and herbal remedies are used to treat it.Long term treatment might be required for such cases.

I hope you got the answers your required.Don't hesitate to ask any remaining doubts regarding your problem.

Regards

Dr.Tharun
Customer: replied 1 year ago.

Ok..a few questions for clarification please.


 


I take from what you are saying that my urination patterns are not particularly suggestive of cancer. Is this correct?


 


I am on a 10 day regimen of CIPRO


 


Is a PSA 5 without urination symptoms more or less suggestive of anything?


 


Is there a correlation between the PSA number and Cancer? ( is a 5 less, more or not related to the chance it could be cancer?)


 


 


 


 

Expert:  Dr. Tharun replied 1 year ago.
HI

There are no particular urinary symptoms suggestive of cancer except blood in urine.

PSA is not a very specific test and we should not read too much into it.But generally it is understood that in PSA with symptoms , there are high chances that infection or the enlargement of the prostate is causing the elevation.If there are no symptoms then that aspect is gone and so cancer stands equal chances of being diagnosed as an infection or just an enlargement.

PSA of more than 4 is regarded as high.But values between 4 to 10 are the most inconsistent to diagnose prostate cancer and there are lot of false positives .

Regards

Dr.Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3593
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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Dr. Tharun
Dr. Tharun
Senior Registrar Dept of Urology
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MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.