In my case the DRE from the Uro was a lot more intense and thorough than the one from my PCP who "thought there might me some firmness". The Uro got in there and really poked around. So much so, that at one point I squirted on the table. He identified all kinds of things before the biopsy and knew where to punch when he did it. (He also found my 2008 pocket notebook that I misplaced the previous year.
It is worth going to an expert.
DX Age 56
. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2
. Biopsy 6/10/09
: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative. RP DaVinci -7/21/2009
@ Univ of Roch Medical Center
Left nerve gone, right partial spared. Catheter removed - 7/31/2009
Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm,
location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX Post Surgery Status: Potency -
12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next? See Uro 1/20/10 Incontinence -
8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day
1/11/10 6 months: Still 3 pads but leak is now 320 ml (5 day avg.)Post Surgery PSA -
9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.