Brand new to this forum. 50 years old. Have had 2 bad cases of prostatitis. First was in May16. second was in Sep16. On Tamsulosin 4mg daily since May16. 05Sep17 had a PSA done - 6.4. Went on antibiotics for 2 weeks. Redid PSA 28Oct17 after antibiotics - 2.04. DRE - was told nothing noteworthy except that I have a large prostate (36CC-measured with ultrasound).
Previously, In May16... came down with a UTI - was Septic (minor - 6 hour visit to ER). local Hospital (small-local) in Southern AZ diagnosed the UTI - turned out also to be an ESBL resistant E-Coli infection. Had to take a different antibiotic for a month to clear it. Mayo Clinic in Phoenix said it was prostititis. Have taken the flomax since. Apparently, was not emptying bladder completely due to Prostititis. Had almost no symptoms before I got very ill with the septis/UTI. PSA during annual physical in Apr16 was 2.77.
Going back further... AUG 2010, during Army retirement physical. PSA was 8.5. Was given antibiotics. PSa went back to below 3 a month later. Still had biopsis - all 12 cores negative. Looking back - not sure why I agreed to a biopsis. Between 2010 and May2016... no symptoms that I remember.
Symptoms since May 2016.... when things are good.... slightly reduced urine flow. slow start usually. weak stream sometimes - mostly at night when I wake up 2x/night to piss. Slow start after sex (2 min to piss on average afterwards). When things are bad like back in September - i get a low grade feeling all the time like I need to piss but there is nothing or little there when I try to go. No ED ever. Only issue I have now (seems like it's maybe permanent) is slight difficulty urinating at night or when I have to hold it... then I need to piss maybe 2 times within a few minutes to get rid of everything.
QUESTION: The Urologist now wants me to do the new 4K score test after my last PSA went back to 2.04. Only question is - is the test worth it from a diagnostic standpoint? My concern is that - given my history... if I get hit with future episodes of prostititis, or have high PSAs - will I be more apt to need to go and run out for a new biopsis? Biopses are a particular concern for me now, since I had an resistant bacterial infection. I am at a higher risk for resistant infections now given the previous one, and don't want to get cornered into biopses all the time.
I am set up to do the 4k score in the next 2 weeks. Am told they'll still do a biopsis (local urologist)... if the 4K comes back over 7 which would indicate I need a biopsis - If I do have to get a biopsis, I plan to go to Mayo for an MRI first. I really want to avoid the biosis when/if I can due to risk of infection.
When my PSA came back 2.04 back in early November after antibiotics - thought I was in the clear.... til my local urologist called and said he wanted to do the 4k?????
I trust the local urologist as much as I trust the one at Mayo... just my gut. Just worried that the 4K will make me live under a shadow.
Any insights would be very very gratefully appreciated!!
Post Edited (InArizona) : 12/16/2017 8:12:22 AM (GMT-7)