How large is a prostate with 3.0 PSA ?
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Last check, my PSA was 3.0. I am just curious, how large can my prostate be. I know the PSA does not correlate well with its size but perhaps statistically it should be within a reasonable limit. I would appreciate any data on your PSA vs size.
I have mild urinary retention from BPH, currently self catherize (CIC) 3-4 times a day. Not having enough problems to ask uro to check for size. Also scared and not wanting to see uro because all uro wanted to do was TURP.
Hank
0 likes, 41 replies
cartoonman hank1953
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DO NOT SUCCUMB TO FEAR! THe Uro-doc CANNOT tell you to have a TURP, he can only recommend! If you want to know size, find out.
As for PSA vs. prostate size, this National Inst. of Health study from 2010 says:
RESULTS
Median preoperative PSA was 4.9 ng/ml (SD ± 4.6), mean prostate size was 51.7 grams, and mean tumor volume was 5.6 cc. PSA had a significant correlation with prostate size only at a prostate weight =54.6 gm (p=0.01). Regardless of prostate size, PSA had a more robust significant correlation with tumor volume than with prostate size (all p<0.0001).
CONCLUSIONS
PSA was significantly correlated with prostate size only in the largest prostate glands, but was significantly associated with tumor volume in small, medium, or large prostates. Thus, PSA continues to be a better marker for tumor volume than for prostate size.
hank1953 cartoonman
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arlington hank1953
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Hi Hank,
You may want to google this article: "7 Non-Cancerous Reasons Your PSA Levels May Be High".
Good luck!
hank1953 arlington
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kenneth1955 hank1953
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hank1953 kenneth1955
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Waffalobill hank1953
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hank1953 Waffalobill
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Waffalobill hank1953
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PSA I don't remember. He told me the range and I was at the very bottom. Size I never asked. But was told by uro and his assistant, who I saw once, that it was huge. Esp for a guy my age. Labs came back twice no cancer.
kenneth1955 Waffalobill
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The prostate size can be anything and it may not cause. 2014 my prostate was the size of a lemon. That is when I had my Uro-lift. My prostate was closed together and I had to force myself. After the urolift had another PSA it was 4.0 And last year my prostate got smaller and it PSA was 0.7. Don't rush into anything because it will change Ken
hank1953 kenneth1955
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Hank
kenneth1955 hank1953
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I did not do much. I took cisprofloxacin 1000 mg for a month for a prostate infection and I all way take a vitiman D. My urologist thinks it was the cispro but he said he can't be sure When he went in to check my stricture one of the implants got loose and had to have it repaired he had to tighten the other three. I'm glad it gor smaller I wish I know why so I could help others. I also drink alot of cranberry juice but cant driink it know I am on 2 blood thinners Ken
Waffalobill kenneth1955
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kenneth1955 Waffalobill
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Howard31850 hank1953
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Hello Hank,
PSA is a protein excreted by the epithelial cells that line the pores of the prostate gland. So for a healthy prostate the rule of thumb is that the serum measure of PSA (in the blood) is about 0.12 (ng/ml) / gm of prostate. So if your blood PSA is 3.0 (ng/ml) then that would mean your prostate size is about 25 gm which is very good and should not cause you retention problems.
But since you are having retention problems it might be worth getting an ultrasound to see if you have any bladder neck obstructions from bladder stones, or urethral strictures or a large median lobe growing into your bladder neck. A cystoscopy would also be worthwhile. I don't see how your uro can be recommending at this point. Maybe try a different one if feasible?
Regarding PSA and prostate size, my prostate was 280gm but my PSA was only 12. By the above formula my PSA should have been over 30. What is more important than the PSA value is the PSA density which divides the PSA by the measures prostate size. This is another reason to get an ultrasound - so the uro can measure your prostate size.
If you are needing to CIC (which I do as well), you should find out the cause of your retention long before considering any surgery (I refuse surgery though I had a failed PAE last summer).
Bottom line: if your uro scares you then find another uro!!
Take care.
Neil
hank1953 Howard31850
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My retention problem was most likely caused by both BPH and long time high liquid consumption + trying to hold it in. Right now I am doing CIC and waiting for the right procedure to come along. I like to know my size to see what procedure I qualify.
Hank
hank1953 Howard31850
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Hi Neil, I had a kidney + prostate ultrasound but uro did not tell me the size and I was too dumb to ask. Also, uro suggested TURP so it can not be that large, can't it ?
Hank
Howard31850 hank1953
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Having said that you need to determine the cause of your retention problems. Is it a large prostate clamping down on your urethra or some bladder neck obstruction like a large median lobe or bladder stones or a number of other things. So you need to have a discussion with your uro and ask for ultrasounds at a minimum to determine you prostate size and possible obstructions.
It is also possible that your LUTS problems has nothing to do with your prostate. It seems your prostate is a normal size for your age and your PSA of 3.0 can be elevated due to many other things like recent sex or CIC or prostatitis. It is the trend of the PSA value over time that is important and not just one or two elevated values.
But your LUTS symptoms can also be due to your bladder wall muscle not contracting fully. This can be due to that muscle not getting enough blood due to diabetes or athersclerosis/hypertension and other causes which have nothing to do with the prostate. So if you have any of those conditions you should look at that too. Urodynamics testing can shed some light on the health of your bladder muscle (the detrusor muscle).
So you need to sit down with your uro as well as your primary care doctor and figure out an investigative approach to find the cause of your retention. It is way too early to try something like Turp or any other procedure. You are very smart to be doing CICas it gives you all the time in the world to figure out what is happening.
Good luck.
Neil
Howard31850 hank1953
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I forgot to ask you if you keep track of how much you pee each time naturally (NV-natural void) and how much you take out with the catheter (CV- catheter void). It is improtant to keep track of those numbers.
Neil
hank1953 Howard31850
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Hank
arlington hank1953
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Your situation/schedule sounds similar to mine. Do you have an enlarged median lobe?
hank1953 arlington
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I don't know much about my prostate. Perhaps I should try to find out. However, without any serious problems, I am afraid insurance may not cover it. Uro did not suggest anything other than TURP, lol.
Hank
hank1953 arlington
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Hank
arlington hank1953
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My PSA was normal in 2013. Haven't had it checked since then as I've been told the readings may be artificially skewed while going through this.
Leading up to my PAE in Sept '15 (which only helped about 5% - probably due to enlarged median lobe). It was estimated/calculated atabout 40-50, 55 and 57 (the latter 2 readings were from MRI & CTSCAN).
I had developed a case of hives in 2014 and was prescribed 3 OTC antihistamines which sent me in to acute urinary retention. I had to go to the ER, was catheterized and peed about 1500cc's. I tried to get off the catheter 3 times in the next month but each time I ended up back in the ER or uro's office to get catheterized. They put me on an indwelling catheter for 2 /1/2 months until I said "Uncle" and learned how to CIC. Self-cathing is so much better that I would always recommend learning it immediately when faced w/ the choice of that or indwelling Foley. I have still not come back from this.
I had a very small initial imrpovement after the PAE but over the past 6 months my natural v cath ratios are horrible (about 1/50, whereas for the preceding 2 years they had been about 1/1) and I'm having to catheterize about 4-5 times daily.
Like you, I'm taking the watch and wait approach re another procedure and am reluctantly content to contine CIC'ing. I still think the PAE is a viable option if they can figure out how to help those w/ enlarged median lobes.
I'm taking Rapaflo 8mg and have been on some type of med since 2014. I wanted to take Alfuzosin because of better side effect profile but I had a reaction.
Best of luck!
kenneth1955 hank1953
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Hank Look into other procedures before you do anything. There are many less invasive things out there. Don't like the insurance company push you into any treatment Take care Ken
hank1953 arlington
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Hank
hank1953 kenneth1955
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Howard31850 hank1953
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Hi Hank - I don't think you should worry at this point about the size of your prostate until you know the cause of your retention. I had an almost 300gm prostate yet I could still natural void ok with some retention. Other men cannot void at all with prostates ten times smaller. The prostate has many sections to it so in my case I had very long lateral lobes but with no median lobe protruding into the bladder neck. This prostate structure was discovered after I insisted on a trans urethral ultrasound and a trans peirtoneal ultrasound to look at my bladder and kidneys. Both ultrasounds took only 5 minutes each and were done at the same time. My uro just wanted to do Turp on me for many years so after that I fired him (or he fired me?) and I got a better uro. Then I had a cystoscopy to confirm all this up close and personal which also was easy and took just a minute.
What I am saying is that with a stable PSA of 3 for many years and an inferred small prostate it should be fairly easy to determine the cause of your retention. Then a targeted treatment can be designed for you of which there are a great many non-invasive or minimally-invasive procedures and/or drugs that should help you. Neil
hank1953 Howard31850
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Howard31850 hank1953
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You are welcomed. If you take 2 Tylenol before bed or in the middle of the night after CIC there is nothing to worry about at all. It is only a problem if you take more than 8 a day every day. I don't take it for pain at all - just to relax. I also tried magnesium with melatonin but did not see much of a difference. take care. Neil
hank1953 Howard31850
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arlington hank1953
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hank1953 arlington
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Howard31850 hank1953
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Hi Hank and Arlington - I also had a PAE at UNC back in August. I was told before and after the procedure I was an excellent candidate beause I had a very large prostate with well developed arteries and no median lobe or other obstruction. The procedure was a huge success according Dr. I. But I have seen no improvement in my IPSS scores/symptoms (high 20s). I had Dr. I order a 3T-MRI for me the end of October to see why it failed but he still has not interpreted the images for me. I had to go to another IR who is really great (Dr. Karamanian in Houston).
Anyway now that I can do CIC I am with you Hank and will not try any other procedures until something really benign comes along.
I did not find that ibuprofen helped me much but steroids like prednisone cleared up all my BPH symptoms but unfortunately that is a dangerous drug.
Take care
Neil