Understanding Chronic Prostatitis: Symptoms, Treatments, and Management
Prostatitis Hello Doctor, I would like to ask a few questions regarding chronic prostatitis. I have undergone two semen cultures, which repeatedly showed gastrointestinal bacteria and Staphylococcus epidermidis. I have also taken three courses of quinolone antibiotics (Ciprofloxa...
Dr. Li Xinyi Reply:
Enterococcus generally exhibits strong antibiotic resistance, and bacteria are difficult to eradicate within the prostate. However, immune resistance and overall health are definitely correlated, so maintaining a positive mood, healthy diet, and regular exercise is important. As ...[Read More] Understanding Chronic Prostatitis: Symptoms, Treatments, and Management
Understanding Prostate Cancer Treatment and Diagnostic Options
Treatment of prostate cancer? Hello Doctor, my father was diagnosed with stage IV prostate cancer with bone metastasis in early November last year. His initial PSA level was 256. He is currently receiving monthly injections of Enzalutamide and taking oral medication, which is Bic...
Dr. Li Minghui Reply:
Hello: Please discuss your bone pain issues with your attending physician. Depending on the size of the hospital, it is generally experienced that pain may occur before medication is taken, and pain relief medication may still be needed after treatment. Additionally, health insur...[Read More] Understanding Prostate Cancer Treatment and Diagnostic Options
Managing Advanced Prostate Cancer: Treatment Options and Diagnostic Clarity
Stage IV prostate cancer Hello Doctor, my father was diagnosed with stage IV prostate cancer with bone metastasis in early November last year. His initial PSA level was 256. He is currently receiving monthly injections of Enzalutamide and taking oral medication, which is Bicaluta...
Dr. Du Shixi Reply:
Hello: Please discuss your bone pain issues with your attending physician. Depending on the size of the hospital, it is generally experienced that pain may occur before medication is taken, and pain relief medication may still be needed after treatment. Additionally, health insur...[Read More] Managing Advanced Prostate Cancer: Treatment Options and Diagnostic Clarity
Understanding Bladder Tumor Growth and Quality of Life After Cystectomy
The growth rate of bladder tumors and the quality of life with an artificial bladder? Hello Doctor: In January, I experienced hematuria and sought medical attention, but no tumors were found during the examination. I continued to be monitored, but since there was no improvement, ...
Dr. Li Xinyi Reply:
Based on your description, the behavior of the tumor appears to be more aggressive. You should seek treatment at a large medical center, such as National Taiwan University Hospital or Chang Gung Memorial Hospital. A total cystectomy will certainly impact your life, and I believe ...[Read More] Understanding Bladder Tumor Growth and Quality of Life After Cystectomy
Understanding Bladder Tumor Progression and Quality of Life After Cystectomy
The rate of change in bladder tumors and the quality of life with an artificial bladder? Hello, Doctor: I would like to ask you about my situation. Since January, I have had painless hematuria and did not have any tumors detected during medical examinations. I have been following...
Dr. Du Shixi Reply:
Hello: The pathology report of the excised tumor may indicate varying degrees of malignancy, with more aggressive tumors growing faster. After tumor resection, subsequent treatment will be arranged based on the surgical staging; some patients may only require monitoring, while ot...[Read More] Understanding Bladder Tumor Progression and Quality of Life After Cystectomy
Understanding Prostate Enlargement: Symptoms and Early Detection of Bladder Cancer
Benign Prostatic Hyperplasia (BPH) Dear Director Li: Regarding the causes and symptoms of prostate enlargement, are they not very similar to the symptoms of bladder cancer? Both can present with hematuria, urgency, frequency, and a feeling of incomplete bladder emptying. I person...
Dr. Li Minghui Reply:
Hello: It is best to use cystoscopy for examination to gain understanding. Wishing you good health.[Read More] Understanding Prostate Enlargement: Symptoms and Early Detection of Bladder Cancer
Understanding Enlarged Prostate: Symptoms and Early Detection of Bladder Cancer
Benign prostatic hyperplasia (BPH) Dear Doctor: Are the causes and symptoms of prostate enlargement very similar to those of bladder cancer? Both can present with hematuria, urgency, frequency, and a sensation of incomplete bladder emptying. I have experienced painless hematuria,...
Dr. Du Shixi Reply:
Hello: It is best to use cystoscopy for examination to gain understanding. Wishing you good health.[Read More] Understanding Enlarged Prostate: Symptoms and Early Detection of Bladder Cancer
Managing Persistent Elevated PSA Levels After Two Benign Biopsies
If the PSA levels are abnormal and persistently elevated, and two biopsies have confirmed benign results, the next steps in management may include: 1. **Active Surveillance**: Continue monitoring PSA levels and perform regular follow-up exams, including digital rectal exams (DRE...
Dr. Cai Zhuorong Reply:
In addition to PSA and free PSA, the volume of the prostate and the PHI score can also be considered for a comprehensive assessment. Furthermore, whether the MRI conducted in September raises suspicion of potential prostate cancer lesions is also an important reference. Evaluatin...[Read More] Managing Persistent Elevated PSA Levels After Two Benign Biopsies
Understanding Prostate Fluid: Timing and Fertility Chances Explained
Prostatic fluid Hello, doctor. I would like to ask how long it takes for prostatic fluid to be secreted after entering the female vagina, and what is the probability of conception after it is secreted?
Dr. Du Shixi Reply:
Hello: Everyone is different; some are faster while others are slower. It's hard to explain. Prostate fluid has a low chance of leading to conception, but it is still possible to conceive. Wishing you good health.[Read More] Understanding Prostate Fluid: Timing and Fertility Chances Explained
Understanding Rising PSA Levels: When to Seek Further Evaluation
PSA levels have been rising in recent years? Hello, Dr. Hsu. My PSA levels have been rising over the past five years, starting from 9.7 and increasing to 14.3. The doctor performed a digital rectal exam and a biopsy, which showed benign results with benign prostatic hyperplasia. ...
Dr. Xu Wencang Reply:
Is there any abnormality in the MRI? A biopsy can be performed, and a transurethral resection of the prostate (TURP) or laser prostatectomy can be done, followed by pathological examination.[Read More] Understanding Rising PSA Levels: When to Seek Further Evaluation
Understanding Nocturia and Penile Enlargement: Causes and Concerns
Nocturia accompanied by penile engorgement? Hello Dr. Lee: Recently, I have been experiencing nocturia accompanied by penile engorgement, which makes it difficult to urinate. I have to stand for a while before I can urinate, and the amount is not much, and I feel like I can'...
Dr. Li Xinyi Reply:
It doesn't sound like a disease issue, but could it be related to medication you are taking? If you have concerns, it's advisable to see a urologist for an examination and discuss it with your doctor.[Read More] Understanding Nocturia and Penile Enlargement: Causes and Concerns
Understanding Low Free PSA/Total PSA Ratios: When to See a Urologist
Free PSA / Total PSA is below the normal range? Hello, Doctor. I recently received my health check report and noticed that my free prostate-specific antigen (FPSA) to total prostate-specific antigen (TPSA) ratio is 0.18 (the report suggests it should be greater than 0.25). Upon r...
Dr. Du Shixi Reply:
Hello: As long as the PSA levels are normal, this ratio can be of less concern. Generally, it is recommended for individuals over 45 years old to have a PSA test once a year. Wishing you good health.[Read More] Understanding Low Free PSA/Total PSA Ratios: When to See a Urologist
Understanding Low Prostate Fluid and Erectile Issues in Young Men
There is very little prostatic fluid, almost none at all? Hello, doctor! My boyfriend believes that the following issues are normal, but they differ from what I've learned, so I would like to ask on his behalf. (My boyfriend is 25 years old.) Here's the situation: whene...
Dr. Du Shixi Reply:
Hello: Please seek medical examination. The amount of prostatic fluid varies from person to person; some may have more, while others may have less. As long as the semen analysis is normal, that is sufficient. Regarding erectile function, whether it has always been this way or has...[Read More] Understanding Low Prostate Fluid and Erectile Issues in Young Men
Understanding Prostate Ultrasound Results: Next Steps After Adenoma Diagnosis
Prostate ultrasound Hello Doctor: I have completed a transrectal ultrasound (TRUS) examination of the prostate, and the results are as follows: it indicates the presence of an adenoma. Should I undergo a pelvic MRI or a biopsy? TRUS Echo Prostate size: Width: 4.42 cm, Height: 2.8...
Dr. Chen Jiansheng Reply:
Please return for a follow-up appointment.[Read More] Understanding Prostate Ultrasound Results: Next Steps After Adenoma Diagnosis
Combining Radium-223 with Second-Line Hormonal Therapy: Key Considerations
The issue of combining Radium-223 with second-line hormonal therapies? Hello, I have stage IV prostate cancer with bone metastasis and have developed bone pain. My PSA level has exceeded 100, and I am currently awaiting Radium-223 treatment. I would like to inquire about the use ...
Dr. Jian Weihong Reply:
Hello: Based on my understanding, Radium-223 (such as Xofigo) is to be used under specific conditions and cannot be combined with enzalutamide. It is indicated for the treatment of castration-resistant prostate cancer (CRPC) patients who have symptomatic bone metastases and no vi...[Read More] Combining Radium-223 with Second-Line Hormonal Therapy: Key Considerations
Managing Bone Metastasis in Stage IV Prostate Cancer: Treatment Insights
Stage IV prostate cancer with bone metastasis? Hello, I have stage IV prostate cancer with bone metastasis and have developed bone pain. My PSA level has exceeded 100, and I am currently waiting for radium-223 treatment. I would like to inquire about the use of enzalutamide to su...
Dr. Du Shixi Reply:
Hello: Based on my understanding, Radium-223 (such as Xofigo) is restricted for use in the treatment of castration-resistant prostate cancer (CRPC) patients with symptomatic bone metastases and no organ metastases. Patients must meet the following three criteria: 1. The patient m...[Read More] Managing Bone Metastasis in Stage IV Prostate Cancer: Treatment Insights
Understanding Ejaculation Issues: When Only Prostate Fluid is Released
Anejaculation In the past, ejaculation was achieved through grinding methods, but later I read articles stating that such methods should not be used. However, in the past few weeks, using a piston-style masturbation technique has only resulted in the release of prostate fluid. Do...
Dr. Du Shixi Reply:
Hello: It is recommended to seek medical examination, as it may be due to habits. Wishing you good health.[Read More] Understanding Ejaculation Issues: When Only Prostate Fluid is Released
Is It Chronic Prostatitis? Understanding Urinary Symptoms and Diagnosis
Is it chronic prostatitis? I have seen two doctors who both diagnosed me with overactive bladder. My symptoms include a strong sensation of residual urine accompanied by a burning sensation near the prostate area, occurring less than two minutes after urination. However, if I can...
Dr. Li Xinyi Reply:
Based on your description, it does seem like there is a chronic infection in the prostate that has not been resolved. Is there any connection with the COVID-19 infection? It appears that a follow-up appointment is necessary to discuss this further with your physician.[Read More] Is It Chronic Prostatitis? Understanding Urinary Symptoms and Diagnosis
Burning Sensation at Urethra During Bowel Movements: Causes and Solutions
Burning and painful sensation at the urethral opening? Hello, doctor. I usually have no issues with urination, but I often experience a sudden burning pain at the urethral opening while squatting on the toilet to have a bowel movement. This is accompanied by post-void dribbling, ...
Dr. Xu Wencang Reply:
Outpatient examination.[Read More] Burning Sensation at Urethra During Bowel Movements: Causes and Solutions
Understanding Ejaculation Issues: A Guide for Young Men
I have never ejaculated during masturbation? Hello, doctor. I am currently 19 years old and have tried masturbation about ten times in my life, but I have never ejaculated. I experience nocturnal emissions, but only once or twice every month or two, which makes me feel a bit of p...
Dr. Du Shixi Reply:
Hello: If you have already consulted a doctor and all tests are normal, it may be related to your constitution and does not require special concern. Since the orgasm process is not completed, ejaculation will not occur. If there is not much excitement in response to adult films, ...[Read More] Understanding Ejaculation Issues: A Guide for Young Men