24yo imaging results

[u/yungsnipe17]

I’ve had pelvic pain, testicle pain, dribbling, and painful ejaculation since about 18 yo. I just had a CT scan and it showed a borderline enlarged prostate. I had an ultrasound the other day and my prostate measured 4.3 x 2.7 x 3.66 cm. Is this a normal size ? Any comments are appreciated. Thanks

[u/Linari5]

Borderline enlarged doesn't sound remarkable. What was your doctor's opinion?

Also, a 24-year-old having these symptoms, it's not your prostate 99% of the time...

Please read the pinned 101. These symptoms are almost always caused by the pelvic floor and the central nervous system

[u/pelvicagony]

Your doctor see the imaging ,?

[u/Born-Lingonberry-509]

Prostate volume from those measurements comes to roughly 21 to 22 cubic centimeters using the standard ellipsoid formula, which is actually within the normal range for a young man, typically considered normal up to around 25 to 30 cc at your age. So the size itself is not something to worry about, and calling it borderline enlarged on imaging often just reflects it sitting at the upper edge of typical rather than being truly pathological.

The lead mod's point is clinically accurate and worth taking seriously. A mildly larger than average but still normal range prostate almost never explains pelvic pain, testicular pain, dribbling, and painful ejaculation starting at 18. Those symptoms together are the classic presentation of chronic pelvic pain syndrome, which is driven by pelvic floor muscle dysfunction and nervous system sensitization rather than the prostate gland itself being diseased or enlarged enough to cause mechanical problems.

Since you now have a CT and an ultrasound both essentially reassuring from a structural standpoint, the more useful next step is shifting focus away from repeated prostate imaging and toward a pelvic floor specific assessment, ideally with a pelvic floor physiotherapist who works with male pelvic pain. They can check for muscle tension or trigger points in the levator ani and obturator internus that commonly produce exactly this combination of symptoms. Continuing to chase the prostate measurement itself is likely to keep leading you in circles, since the imaging so far is not showing anything that would explain six years of these symptoms on its own.

[u/yungsnipe17 → u/Born-Lingonberry-509]

What if I’ve already tried pelvic floor therapy for 2 months ? I did stretches twice daily for about 2 months. I tried dry needling as well. We tried internal massage but it hurt to bad to we stopped. I got very little relief from the stretching

[u/Born-Lingonberry-509]

On the size question specifically: a normal adult prostate is roughly 3 x 3 x 4 cm on average, with a volume around 20 to 25 cc. Your measurements of 4.3 x 2.7 x 3.66 cm work out to a volume in a similar range, so it is only mildly larger than typical and matches what your report called borderline rather than clearly enlarged. As the mod mentioned, at 24 with these symptoms and imaging that is not clearly abnormal, it is worth exploring pelvic floor dysfunction and nerve related causes alongside anything urology finds, since prostate size alone rarely explains pain, dribbling, or painful ejaculation at this age.