Q. Do enlarged prostate of 4 cm suggest prostatitis?

Answered by
Dr. Shahil Khant
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 10, 2020 and last reviewed on: Mar 14, 2020

Hi doctor,

I am a 52-year-old man. My height is 6' 2" and I weigh about 215 lbs. I work out three times a week. I am typically healthy, although under a lot of stress in general. I drink more alcohol than I should, approximately three glasses of wine each night. I stay away from food and drinks with sugar other than wine typically. My family doctor is English speaking and my urologist is Spanish speaking.

Six months ago, I noticed that I was urinating more often and when I had to go, I felt an urgency to go. Previously, I was told that I had a somewhat enlarged prostate at about 4 centimeters and figured that may have been it or infection and thought that would pass. I recently went to my family doctor and he recommended that I get an ultrasound for the prostate. The radiology stated the below.

Prostate was well visualized and is enlarged measuring 3.7 x 3.7 X 5.4 centimeters. There is a nodule that is pressing into the bladder that measures 1.9 x 2.1 x 2.4 centimeters. This nodule does not have blood flow within as visualized by ultrasound.

My family doctor then sent me to a urologist. I showed him my lab results and he pointed out my PSA level of 1.54. He also pointed out my urine test which said

Specific gravity: 1.015,

Hidden blood: Traces,

Leukocyte esterase: +,

pH 7.0.

I can upload that and the blood test. I will upload the tests, but they are in Spanish, but the technical words are the same.

He also did a rectal exam with his finger. He told me that he thinks that I almost definitely do not have cancer and I have prostatitis. He prescribed Levofloxacin 500 mg once daily for one month, Meloxicam 15 mg, once daily for 14 days, Doxazosin 4 mg, taken every night once daily for two weeks.

I am basically healthy, other than having some short term memory problems and stress. That may be from having a B12 level of 185, which I discovered two weeks ago and have taken two B complex shots for that so far.

After reading the side effects of these prescribed drugs, that scared the crap out of me. I do not want to have some reaction and lose my good health. Are these the drugs you would prescribe? What are your thoughts? He told me no alcohol, coffee or carbonated drinks while taking the medicines. That I can do. Please suggest.

Dr. Shahil Khant

Andrology General Surgery Urology


Welcome to icliniq.com.

I have seen all your reports. (attachment removed to protect patient identity).

I think you are in good shape except for the urine problem. Yes, your urologist has diagnosed you properly. There is no evidence of cancer prostate at present. It looks like prostatitis only. What you need is antibiotics course for one month.

Levofloxacin is the best antibiotic for prostatitis as prescribed by your doctor. Meloxicam is for inflammation and Doxazocin is to relax your prostate muscles. All of these medicines have side effects but they are very rare. We prescribe these medicines regularly and no one had any major side effects. So go ahead and finish your medicines course you will be alright.

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Thank you doctor,

One of the drugs, Doxazosin, is for easier urine flow. I do not have an issue with urine flow and I really do not like the side effects of that drug that I read. I also wonder about the Meloxicam and those horrible side effects. Could I take antibiotics by itself without these or do I need these drugs?

Dr. Shahil Khant

Andrology General Surgery Urology


Welcome back to icliniq.com.

It would be better if you take Doxazocin. Although you do not have a problem with urine flow because it relaxes the muscles around the bladder and prostate and helps in clearing the infection.

You can take Tamsulosin 0.4 mg one at bedtime instead of Doxazocin. It is better than Doxazocin with less side effects. You can avoid Meloxicam if you want. Antibiotic is absolutely necessary.

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