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My urologist has estimated the size of my prostate as 40 mL based on a DRE. Recently, my general practitioner had me undergo a transabdominal ultrasound. The results from that imaging study shocked me. My prostate size according to the ultrasound is 145 mL!!? I questioned my GP and he said that estimating from DRE is inaccurate. I questioned my urologist and he agreed. But my uro had told me that the size of my prostate was similar to a small lemon. The ultrasound suggests it is more like a large orange. At any rate my GP met up with the radiologist to look at the images again and they came to the same conclusion - namely that 145 mL is correct.
I am very upset with my urologist. Although I realize that a DRE is a "coarse" procedure for measuring the prostate volume, a difference of over 350% is outrageous in my mind. If the accuracy is this poor, then urologists should not provide PV estimates via DRE; but should instead use ultrasound (TRUS is the standard, but according to my uro, doesn't work well if the prostate is bigger than 100 mL).
The urologist and GP kept trying to tell me that it is the transition zone which is important and the overall size is not that important. Okay, but my point to my urologist is that having such a large prostate can remove potential treatment options from consideration. For example, TURP is only recommended for prostates 100 mL or less in size. He begrudgingly agreed on this point.
I am now on Avodart in an attempt to reduce the prostate size and my symptoms (which are moderate although I am having an increasing number of short lived acute urinary retention episodes).
The point of this post is to not trust the PV estimated from a DRE. Instead insist that your urologist conduct an ultrasound study. I meet with my new urologist this coming week.
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