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Hello! This Question Pertains To My Husband, Who Is 53
Question: Hello! This question pertains to my husband, who is 53 years old. Although he has no urinary symptoms or any symptoms otherwise, his PSA tests showed levels as follows: On 3/17/17 Total 2.8, Free .2 and %Free 7. On 10/15/18 Total 2.6, Free .2 and %Free 8. Just a few weeks ago Total 3.3, Free .2, %Free 6. As a result, he visited a urologist, who ordered an MRI of his prostate. I am attaching a report of that MRI. He visited his urologist today who prescribed ibuprofen, and a 10 day course of Levaquin; the urologist also ordered a repeat PSA test for XXXXXXX and a follow up appointment in XXXXXXX He indicated that if the level does not go down, he will do a biopsy. Can you please review the same, as I have the following questions:
1) Is there anything terribly concerning on the report? I see there is reference to chronic prostatitis, mild BPH and also some suspicious areas seen, although the report says low probability of malignancy...?
2) Is the PI-RADS score of 2 relatively reassuring?
3) My husband does have severe degenerative changes in his right hip as noted on the report. He has had hip pain for several years and it has recently exacerbated. He will be visiting a osteopathic surgeon in May. I read online that muscle and nerve damage and issues in the pelvic area can cause inflammation of prostate gland -- do you think that could possibly be a cause of the chronic prostatitis.
4) Do you feel the chronic prostatitis is most likely the cause of the elevated PSA, as opposed to any malignancy?
Thank you so very much for your help and expertise!!
1) Is there anything terribly concerning on the report? I see there is reference to chronic prostatitis, mild BPH and also some suspicious areas seen, although the report says low probability of malignancy...?
2) Is the PI-RADS score of 2 relatively reassuring?
3) My husband does have severe degenerative changes in his right hip as noted on the report. He has had hip pain for several years and it has recently exacerbated. He will be visiting a osteopathic surgeon in May. I read online that muscle and nerve damage and issues in the pelvic area can cause inflammation of prostate gland -- do you think that could possibly be a cause of the chronic prostatitis.
4) Do you feel the chronic prostatitis is most likely the cause of the elevated PSA, as opposed to any malignancy?
Thank you so very much for your help and expertise!!
Hello! This question pertains to my husband, who is 53 years old. Although he has no urinary symptoms or any symptoms otherwise, his PSA tests showed levels as follows: On 3/17/17 Total 2.8, Free .2 and %Free 7. On 10/15/18 Total 2.6, Free .2 and %Free 8. Just a few weeks ago Total 3.3, Free .2, %Free 6. As a result, he visited a urologist, who ordered an MRI of his prostate. I am attaching a report of that MRI. He visited his urologist today who prescribed ibuprofen, and a 10 day course of Levaquin; the urologist also ordered a repeat PSA test for XXXXXXX and a follow up appointment in XXXXXXX He indicated that if the level does not go down, he will do a biopsy. Can you please review the same, as I have the following questions:
1) Is there anything terribly concerning on the report? I see there is reference to chronic prostatitis, mild BPH and also some suspicious areas seen, although the report says low probability of malignancy...?
2) Is the PI-RADS score of 2 relatively reassuring?
3) My husband does have severe degenerative changes in his right hip as noted on the report. He has had hip pain for several years and it has recently exacerbated. He will be visiting a osteopathic surgeon in May. I read online that muscle and nerve damage and issues in the pelvic area can cause inflammation of prostate gland -- do you think that could possibly be a cause of the chronic prostatitis.
4) Do you feel the chronic prostatitis is most likely the cause of the elevated PSA, as opposed to any malignancy?
Thank you so very much for your help and expertise!!
1) Is there anything terribly concerning on the report? I see there is reference to chronic prostatitis, mild BPH and also some suspicious areas seen, although the report says low probability of malignancy...?
2) Is the PI-RADS score of 2 relatively reassuring?
3) My husband does have severe degenerative changes in his right hip as noted on the report. He has had hip pain for several years and it has recently exacerbated. He will be visiting a osteopathic surgeon in May. I read online that muscle and nerve damage and issues in the pelvic area can cause inflammation of prostate gland -- do you think that could possibly be a cause of the chronic prostatitis.
4) Do you feel the chronic prostatitis is most likely the cause of the elevated PSA, as opposed to any malignancy?
Thank you so very much for your help and expertise!!
Brief Answer:
Please read below
Detailed Answer:
Hi Mbaquiline,
Thank you for your questions and report. To answer them chronologically:
1) There is nothing terribly concerning on the MRI report. What the radiologist sees is probably the chronic changes associated with benign prostate hyperplasia and/or chronic prostatitis.
2) PI-RADS 2 means that clinically significant cancer is unlikely.
3) Chronic prostatitis is typically caused by previous genitourinary infection. Degenerative hip changes are an unlikely cause of prostatitis.
4) Chronic prostatitis or BPH are more likely explanations for the increased PSA rather than cancer. However, a transrectal ultrasound and biopsies are a good way of being certain.
Hope this helps. Please let me know if you have further questions.
Please read below
Detailed Answer:
Hi Mbaquiline,
Thank you for your questions and report. To answer them chronologically:
1) There is nothing terribly concerning on the MRI report. What the radiologist sees is probably the chronic changes associated with benign prostate hyperplasia and/or chronic prostatitis.
2) PI-RADS 2 means that clinically significant cancer is unlikely.
3) Chronic prostatitis is typically caused by previous genitourinary infection. Degenerative hip changes are an unlikely cause of prostatitis.
4) Chronic prostatitis or BPH are more likely explanations for the increased PSA rather than cancer. However, a transrectal ultrasound and biopsies are a good way of being certain.
Hope this helps. Please let me know if you have further questions.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Please read below
Detailed Answer:
Hi Mbaquiline,
Thank you for your questions and report. To answer them chronologically:
1) There is nothing terribly concerning on the MRI report. What the radiologist sees is probably the chronic changes associated with benign prostate hyperplasia and/or chronic prostatitis.
2) PI-RADS 2 means that clinically significant cancer is unlikely.
3) Chronic prostatitis is typically caused by previous genitourinary infection. Degenerative hip changes are an unlikely cause of prostatitis.
4) Chronic prostatitis or BPH are more likely explanations for the increased PSA rather than cancer. However, a transrectal ultrasound and biopsies are a good way of being certain.
Hope this helps. Please let me know if you have further questions.
Please read below
Detailed Answer:
Hi Mbaquiline,
Thank you for your questions and report. To answer them chronologically:
1) There is nothing terribly concerning on the MRI report. What the radiologist sees is probably the chronic changes associated with benign prostate hyperplasia and/or chronic prostatitis.
2) PI-RADS 2 means that clinically significant cancer is unlikely.
3) Chronic prostatitis is typically caused by previous genitourinary infection. Degenerative hip changes are an unlikely cause of prostatitis.
4) Chronic prostatitis or BPH are more likely explanations for the increased PSA rather than cancer. However, a transrectal ultrasound and biopsies are a good way of being certain.
Hope this helps. Please let me know if you have further questions.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr. Christensen! Thank you so very much for your answers -- I appreciate it very much!
Two follow up questions:
1) His urologist ordered a repeat PSA test and said he would do a biopsy if the level has not gone down -- would you agree with that, and that if the level has decreased a biopsy is not warranted?
2) In general, if this was you or a loved one with this type of a report, would you be terribly worried about it?
Thank you again!!
Two follow up questions:
1) His urologist ordered a repeat PSA test and said he would do a biopsy if the level has not gone down -- would you agree with that, and that if the level has decreased a biopsy is not warranted?
2) In general, if this was you or a loved one with this type of a report, would you be terribly worried about it?
Thank you again!!
Hi Dr. Christensen! Thank you so very much for your answers -- I appreciate it very much!
Two follow up questions:
1) His urologist ordered a repeat PSA test and said he would do a biopsy if the level has not gone down -- would you agree with that, and that if the level has decreased a biopsy is not warranted?
2) In general, if this was you or a loved one with this type of a report, would you be terribly worried about it?
Thank you again!!
Two follow up questions:
1) His urologist ordered a repeat PSA test and said he would do a biopsy if the level has not gone down -- would you agree with that, and that if the level has decreased a biopsy is not warranted?
2) In general, if this was you or a loved one with this type of a report, would you be terribly worried about it?
Thank you again!!
Brief Answer:
Repeat PSA is a good idea
Detailed Answer:
Hi again Mbaquiline,
1) I agree that a biopsy is a good idea if the PSA goes up; if it goes down, it is suggestive of either BPH or chronic prostatitis and does therefore not require biopsy.
2) I would not be worried, I suspect that your husband's PSA is caused by either BPH or prostatitis.
Please keep me in the loop and let me know if you have further questions.
Best wishes.
Repeat PSA is a good idea
Detailed Answer:
Hi again Mbaquiline,
1) I agree that a biopsy is a good idea if the PSA goes up; if it goes down, it is suggestive of either BPH or chronic prostatitis and does therefore not require biopsy.
2) I would not be worried, I suspect that your husband's PSA is caused by either BPH or prostatitis.
Please keep me in the loop and let me know if you have further questions.
Best wishes.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Repeat PSA is a good idea
Detailed Answer:
Hi again Mbaquiline,
1) I agree that a biopsy is a good idea if the PSA goes up; if it goes down, it is suggestive of either BPH or chronic prostatitis and does therefore not require biopsy.
2) I would not be worried, I suspect that your husband's PSA is caused by either BPH or prostatitis.
Please keep me in the loop and let me know if you have further questions.
Best wishes.
Repeat PSA is a good idea
Detailed Answer:
Hi again Mbaquiline,
1) I agree that a biopsy is a good idea if the PSA goes up; if it goes down, it is suggestive of either BPH or chronic prostatitis and does therefore not require biopsy.
2) I would not be worried, I suspect that your husband's PSA is caused by either BPH or prostatitis.
Please keep me in the loop and let me know if you have further questions.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Kampana
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