Prostate Issues: Symptoms, Treatment, and Monitoring

Q: Prostate Issues: Symptoms, Treatment, and Monitoring

Hello： 1. It is recommended to take the medication for a period of time, make lifestyle adjustments, and then try to discontinue it; otherwise, the condition may return quickly. 2. Relaxation is important and should not be minimized. 3. It is difficult to pred

Prostate issues

Hello Doctor, I had a health check-up at the end of July and found some issues with my prostate, so I would like to ask for your advice.
The report shows: > Prostate-Specific Antigen (PSA) 1.40 > Mild Prostatic Hyperplasia (Size: 2.7*4.37*3.74cm => 23.079mL) > Irregular surface at the right lobe, Nature -> Elastic.
The doctor explained that the texture felt soft, so there is currently no need for a biopsy unless the texture changes to hard in the future.
Over the past six months, I have noticed that I have difficulty fully emptying my bladder.
Last week, I visited the urology department to discuss and follow up on the report, and the doctor prescribed Chuanliqing D 0.2mg, one tablet a day for seven days.
After taking the medication for a week, I found that the issue of not fully emptying my bladder has improved, and I did not experience any side effects from the medication.
During my follow-up visit yesterday, the doctor prescribed another month of Chuanliqing D 0.2mg.
I would like to ask the doctor: 1.
If the issue of not fully emptying my bladder improves, can I stop the medication? Or will I need to take it for life? 2.
Does long-term use of Chuanliqing D have a delaying effect on prostate enlargement? Are there any impacts on my health from long-term use? 3.
Is the irregular surface of the right lobe related to prostatic hyperplasia, and what is the clinical probability of malignancy in the irregular area? 4.
How often should I follow up on the irregular surface of the right lobe? Is a digital rectal exam sufficient, or is it necessary to include a transrectal ultrasound? Thank you for your response.

AKUO, 50~59 year old female. Ask Date: 2023/09/01

Dr. Jian Weihong reply Urology

Hello: 1.
It is recommended to take the medication for a period of time, make lifestyle adjustments, and then try to discontinue it; otherwise, the condition may return quickly.
2.
Relaxation is important and should not be minimized.
3.
It is difficult to predict.
4.
Blood tests should be done once a year, digital rectal exams every six months, and ultrasounds annually, of course, based on the outpatient physician's recommendations.
The family history of prostate cancer in your father or grandfather also affects the follow-up interval.

Reply Date: 2023/09/01

More Info

Understanding prostate issues, particularly benign prostatic hyperplasia (BPH) and potential prostate cancer, is crucial for maintaining men's health. Based on your recent health check-up and the findings regarding your prostate, let's address your concerns systematically.

1. Stopping Medication: If your urinary symptoms have improved significantly after taking the medication (Dutasteride, known as "暢利淨D"), it is essential to discuss with your healthcare provider whether you can safely discontinue the medication. In many cases, patients may be able to stop medication if their symptoms are well-managed; however, BPH is a chronic condition that may require ongoing treatment to prevent symptom recurrence. Your doctor will consider your overall health, the severity of your symptoms, and the potential for future complications when making this decision.

2. Long-term Effects of Dutasteride: Dutasteride is known to help reduce prostate size and alleviate urinary symptoms associated with BPH. Long-term use can indeed slow the progression of prostate enlargement and may reduce the risk of acute urinary retention and the need for surgical intervention. However, like all medications, it can have side effects, including sexual dysfunction, breast tenderness, and potential effects on liver function. Regular monitoring and open communication with your healthcare provider are essential to manage any side effects effectively.

3. Irregular Surface and Cancer Risk: The irregular surface of the right lobe of your prostate raises some concerns. While benign conditions like BPH can cause changes in the prostate's texture and shape, irregularities can also be associated with prostate cancer. The likelihood of cancer based on an irregular surface can vary widely, and while some studies suggest that irregularities can increase the suspicion of malignancy, definitive diagnosis typically requires further investigation, such as a prostate biopsy. Your doctor will consider your PSA levels, the texture of the prostate, and any other risk factors when assessing your cancer risk.

4. Follow-up and Monitoring: Regular follow-up is crucial for monitoring prostate health, especially with an irregular surface noted on examination. Typically, follow-up appointments may be scheduled every 6 to 12 months, depending on your symptoms and the findings during examinations. Digital rectal exams (DRE) are essential, but your doctor may also recommend imaging studies like transrectal ultrasound (TRUS) or MRI if there are significant concerns about the irregularity or if your PSA levels change.

In summary, managing prostate health involves a combination of medication, regular monitoring, and lifestyle adjustments. Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding irritants like caffeine and alcohol, can also help manage symptoms. Always consult your healthcare provider for personalized advice and treatment plans tailored to your specific situation. Regular check-ups and open discussions about your symptoms and concerns will help ensure that any potential issues are addressed promptly and effectively.

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