I am consulting you about a prostate gland problem. I am having a problem in passing urine, and there is a pain in the lower abdomen up to the scrotum and the testicles, but no fever yet. I saw the doctor a few days back, and he prescribed a blood test and my PSA level has been > 8 ng/dl. I have symptoms of prostatitis. Around five months back, a urologist did sonography and found a gland that was swollen, with scars on it (from older prostatitis) and a "harder" outer shell consistency. The doctor suggested that I take Ciprofloxacin 500 mg thrice daily for three weeks to avoid a full-fledged infectious syndrome and to drive the PSA value down. I was told that eventually, I should go for a biopsy too. My question is do I need to take the antibiotics treatment? What would be the criteria to apply to the decision? Can a urologist go for a biopsy under the present high PSA levels? Is there a chance that the PSA value will go down again, with or without antibiotic therapy? What is an evidence-based approach (best conduct) in this case?
Thank you for your guidance.
Welcome to icliniq.com.
Prostatitis needs long-term antibiotic treatment if you have symptoms because of that.
A biopsy is indicated in raised PSA (prostate-specific antigen) value if you have ruled out infection or any other benign causes for that.
Yes, there are chances that the PSA value might go down if it is because of infection.
Approach: First of all, we have to rule out prostatitis as a cause of your raised PSA.
If there is confusion then it is better to go for multiparametric MRI (magnetic resonance imaging) of the prostate first.
If it shows a chance of malignancy then better go for a biopsy.
Again, as you said your urologist examined and found a hard gland which could be because of chronic prostatitis or malignancy. But if the whole gland is hard we would have expected a higher PSA level.
The best approach right now for you would be to go for multiparametric MRI prostate.
Thank you for your assessment and advice.
Just to add two more concerns. Can I practice biking under these circumstances, is there any risk? Can I use real lavender oil in my humidifier? Are there any adverse interactions of concern with the prostrate gland hormone system?
Welcome back to icliniq.com.
If you have pain in the perineum because of prostatitis then it may increase during off-road biking as pressure is directly over the prostate.
Lavender oil can be used.
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