I am 42 years old. I have been referred to see a urologist after an irregular DRE (digital rectal examination). My PSA (prostate-specific antigen) score was 0.6. My symptoms are need to urinate all the time and urgency. I have been given three or four antibiotics for what was thought to be prostatitis but have not gained any relief. This has been on and off for 12 months. Urine analysis was also normal.
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PSA (Prostate-specific antigen) is normal. Enlarged prostate can be benign and chronic prostatitis last in prostate cancer. Since PSA is normal, then we need to investigate for chronic prostatitis.
Burning urination or frequency, and difficulty passing urine on long term indicates chronic inflammation of the prostate. For proper diagnosis, we need semen for culture and choose the proper antibiotic, which is needed for the long term about six weeks as antibiotics penetrate the prostatic capsule slowly and require time to treat prostatitis.
Please follow up with semen culture results to give you a proper antibiotic. Note that chronic prostatitis can be bacterial or without bacteria. If the culture is negative, I will start you on different medications. Therefore follow-up is important.
For enlarged prostate, we need to confirm it with ultrasound. If enlarged prostate, then you will start on tablet Tamsulosin 0.4 mg once at night for the long term.
Please follow up with investigations requested.
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