I am worried about my prostate enlargement. Please help.

Question

Hi doctor,

The sudden increase in the size of my prostate from 75 g to 100 g in a year worries me. Three biopsy test results taken before six years were negative. The PSA level stabilized, and free PSA ratio was satisfactory. Please see the enclosed results. My problem is frequent urination.

Answer 1

Hi,

Welcome to icliniq.com.

I think you have undergone extensive prostate biopsy under general anesthesia, and the PSA level (prostate-specific antigen) is not very different from now. The rate of increase of PSA is also fine, and for a large prostate, PSA is on the higher side due to volume. The percentage of free PSA is also fine. I think these facts reasonably rules out the presence of malignancy. The size estimation on ultrasound is not very accurate. So, if you do not have increased severity of symptoms, then it does not matter much to have 100 g prostate. Get your PVR (post-void residual volume) to see how effectively you empty your bladder. If it is less than 50 mL, then I would like to add tablet Tolterodine 2 mg at bedtime along with Tamsulosin (Silodosin and Tamsulosin are equivalent as also judged by you). If not satisfied with medication, then surgery is an option. Consult your specialist doctor, discuss my opinion with him or her and take treatment with consent.