What causes increased night urination in a 63-year-old male with BPH?

Hello doctor,

I am a 63-year-old male diagnosed with BPH (benign prostatic hyperplasia) a year ago. I started taking Finasteride three months ago, but I had to get up at night to urinate three or four times. I cut out Coke and coffee consumption and increased my water intake. My symptoms have greatly improved. Sometimes, I just get up once a night, and sometimes none. Currently, the problem I am experiencing is a slight burning or itchy feeling when urinating, with occasionally a clear discharge started three days ago. I sometimes feel a light pain in my left scrotum. The last time I checked, they said it was a granula. I have no other symptoms, no pain when ejaculating or after sex, and no pain in the perineal area. Before starting Finasteride, I had my most recent PSA (prostate-specific antigen) test three months ago. I am unsure whether the 2.5 ng/mL in my tests is due to BPH or anything else. The same thing happened two months ago with a clear discharge that lasted five or six days and went away. The only common symptom is I started drinking coffee again, like two or three cups daily. I did not use any cream or sugar in my black coffee and did not drink as much water. I am having one cup of coffee daily and drinking a lot of water now that I have seen a urologist. I have no chance of developing sexually transmitted diseases as I have retired and remain close to my wife. I have no history of medical issues, surgery, blood pressure, or smoking. However, my father is 84 years old and was just diagnosed with prostate cancer. Please help.

Thank you.

Hello doctor,

Hello doctor,

Thanks for the reply.

I do not spend time sitting down and take no other medicine. I indulge in sex about once or twice a week. I masturbate three or four times a month. I underwent a PSA (prostate-specific antigen) test two years ago, and my last test was two months ago, which showed 2.5 ng/mL. But then, about a year ago, I felt the urge to pee and consulted a doctor. They said I had a UTI (urinary tract infection) and gave me antibiotics. However, I still had the urge to urinate, so I consulted a urologist. The doctor advised tests and said I had BPH (benign prostate hyperplasia). They suggested I drink lots of water and not drink anything two or three hours before bedtime. It worked. I could sleep seven hours if I followed his directions and sometimes just got up once. I would wake up twice or thrice to pee if I drank one beer at night. Everything was alright until this week. I already had the very slight burning sensation that I have had for a year on and off. I figured it was because of BPH, but I do not even think I mentioned that to my urologist, as it was not that bad. This week, it was itchy while peeing, with a slight burning and clear water-like drop coming out occasionally. If I had dark-colored underwear, it would dry white. But now, the itchy feeling is gone, and the clear water has just about stopped. I felt fine, so I did not know what was happening to me. Is the rise in PSA over two years fine? Is it because of my enlarged prostate or diagnosed with BPH, or could that mean something worse? Please help.

Thank you.

Hello doctor,

Thanks for the reply.

But what about the rise in PSA (prostate-specific antigen) from 1 to 2.5 ng/mL in two years? Is that rise normal when you are just diagnosed with an enlarged prostate? Please help.

Thank you.