Normal PSA - with BPH symptoms

[ziggy256]

40-year-old make been on injectable TRT (Sustanol) for c 10 years

Three PSA tests between 2018, and last week all 0.6 ug/L (<2.5)
Symptoms of BPH frequent urination, hesitancy, weak flow, stop-start, waking up to pee etc (put it down to excessive fluid and caffeine intake, but systems are still there after stopping for 4/5 days)
Was expecting the recent PSA to be high given above, buts it's come back the same.

Waiting to see the doctor, but wondering what else could it be when you have low/normal PSA but all the symptoms for BPH, and prostate cancer are present.

 

[JmarkH]

BPH can be as simple as inflammation or as complex as the moon landing. The good news is there are lots of us with BPH to some degree while still maintaining a low risk of cancer. Have you tried 5mg to 10mg daily tadalafil? It helps me manage BPH and has positive sides on other things like lowering blood pressure.

 

[broker]

I have bph and my psa is .6 as well. It went to .7 once but usually steady at .6.
You have all the symptoms of bph. Another tell tale sign is when you urinate you always feel as if there is one more drop left but you just cant squirt it out. 10-15 minutes later you go again.
flomax, rapaflo work well especially when combined with generic cialis.
if you ignore it and decide to ” live with it”, you can cause damage to the bladder.
i dont know what your dosage is but TRT can speed up bph the same way it can speed up hair loss. Although they have all kinds of studies that claim not to show a correlation between trt and bph, it most definitely has an effect.
if not, then why does finasteride and avodart shrink the prostate?

 

[TRicker]

@ziggy256 I've had very similar symptoms without having an enlarged prostate. I've had PSA's from .9 up to 1.7 (on higher doses of testosterone), and I am 46.
I've had a couple DRE's in the past few years, and recently had a cystoscopy. I'll probably never do a cystoscopy again...it hurt like a mo-f'er, but it was over in about 90 seconds.
My urologist said I had the prostate of a 12 year old, and the cystoscopy showed that I had a tight upper urinary sphincter.
I thought for sure I had bph, but that wasn't the case. The same symptoms can be from a tight pelvic floor, which can be cause by stress, heavy lifting sessions, or just involuntary tightening. There were a few stressful times in the past where my dick actually hurt, I pee'd every 30 minutes, and couldn't sleep because I had to keep going to the bathroom. I thought maybe it was prostatitis, but antibiotics didn't do anything. After a few weeks, it just went away. From time to time, I still get the nighttime urgency and weaker stream, but it's usually a result from stress.
My advice, get the DRE if you feel you need it, but I wouldn't stress out about it, because stress just made my symptoms worse. For a few weeks I was prescribed some xanax and an overactive bladder med just to calm things down, which really helped.

 

[Wilson7]

"The same symptoms can be from a tight pelvic floor" Ask your doc for a script for physical therapy and someone that specializes in pelvic floor dysfunction. The two docs I have spoken to (one at Ohio State and the other at the Cleveland Clinic) feel that most of the BPH symptoms come from a tight pelvic floor, they have had very good results sending patients to PT, but you have to get someone that specializes in PF issues. This goes for prostates of any size. The overall size of the prostate does not always correlated with BPH Sx. DREs are a good backup but would only detect about 30% of PC, now an elevated PSA with a positive DRE, time for an MRI. There are more state of the art tests for PC beyond PSA. If over 4 it should reflex to a % free. You can also consider density (PSA/prostate volume) to keep it simple.