Prostate Issues: Symptoms, Concerns, and Treatment Options

Prostate issues!!

1.
Doctor, I have recently experienced some urinary issues.
After urinating, I often have dribbling, and I need to manually squeeze from the base of the penis to get the residual urine out (which I didn't have before).
I have already consulted a doctor, but they only mentioned a urinary tract infection.

2.
Sometimes after urinating, I feel like there is something (urine) stuck in the penis, but when I squeeze, nothing comes out.
Is this a painful sensation? (I have a high pain tolerance, so it's hard for me to distinguish.) The doctor prescribed medication for urinary obstruction (Urorec).
Does prescribing this medication indicate that I have benign prostatic hyperplasia (BPH)?
3.
Is it possible for a 26-year-old to have an enlarged prostate, or could there be other conditions causing frequent urination and dribbling? I usually only wake up once at night to urinate, and for the past few days, I have been able to sleep until around 6 or 7 AM before needing to urinate.
4.
I have some discomfort in my lower left abdomen and left testicle, but it's not very painful.
5.
I am quite worried about the possibility of having an enlarged prostate.
If I were to pay out of pocket for a prostate examination, how much would it cost?
6.
Could frequent erections (without ejaculation) or a history of excessive masturbation (1-2 times daily) lead to an enlarged prostate? I haven't masturbated in the last three to four months and have been engaging in normal sexual intercourse.

Xiao Zhe, 20~29 year old female. Ask Date: 2016/07/07

Dr. Xie Jiaxing reply Urology

Please go to the outpatient clinic for a urinalysis and physical examination to determine if the symptoms are caused by a urinary tract infection, and then discuss the treatment options.

Reply Date: 2016/07/07

More Info

Understanding prostate issues can be quite complex, especially when symptoms are varied and can overlap with other conditions. Your concerns regarding urinary symptoms, potential prostate enlargement, and associated discomfort are valid and warrant a thorough discussion.

1. Symptoms and Their Implications: The symptoms you describe, such as post-void dribbling (the need to squeeze the base of the penis to expel residual urine), discomfort in the lower abdomen and left testicle, and the sensation of incomplete voiding, can indeed be indicative of prostate issues, but they can also stem from other urinary tract problems. The feeling of having something in the urethra after urination could be related to inflammation or irritation of the urethra or prostate, which can occur due to infections or other conditions.

2. Prostate Enlargement at a Young Age: While benign prostatic hyperplasia (BPH) is more common in older men, younger men can experience prostate issues, including prostatitis (inflammation of the prostate) or other conditions that may mimic BPH symptoms. Your age (26) makes it less likely for BPH, but prostatitis or other inflammatory conditions could certainly be at play.
3. Medication and Diagnosis: The medication you mentioned, likely an alpha-blocker (like tamsulosin, often marketed as UroXatral or similar), is commonly prescribed for urinary symptoms associated with BPH or prostatitis. This does not definitively mean you have an enlarged prostate, but it suggests that your doctor is considering the possibility of prostate-related issues affecting your urinary function.
4. Cost of Prostate Evaluation: The cost of prostate evaluations can vary significantly based on location and healthcare provider. In the U.S., a prostate-specific antigen (PSA) test can range from $30 to $100, while a digital rectal exam (DRE) may be included in a routine check-up. More advanced imaging or biopsies can be more expensive. If you're considering self-paying for these tests, it's best to consult with your healthcare provider for an estimate.

5. Impact of Sexual Activity: Concerns about frequent erections or excessive masturbation leading to prostate enlargement are common, but current medical understanding suggests that normal sexual activity does not cause prostate enlargement. However, excessive sexual activity can lead to temporary inflammation or discomfort in the prostate, which might explain some of your symptoms.
6. Next Steps: Given your symptoms, it would be prudent to follow up with a urologist who can perform a comprehensive evaluation, including a physical examination, urine tests, and possibly imaging studies. They may also consider a prostate exam to assess for any abnormalities. If an infection is suspected, a urine culture can help identify the causative organism and guide treatment.

In summary, while your symptoms could suggest prostate issues, they could also be related to other conditions. A thorough evaluation by a healthcare professional is essential to determine the underlying cause and appropriate treatment. It's important to communicate openly with your doctor about all your symptoms and concerns to ensure you receive the best care possible.

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