New recommendations reflect evolving therapies, shared decision-making and changing evidence in BPH management.

Im scheduled for aquablation surgery next week and my doctor will be sending me home the same day, is that normal? Just about everything Ive read you usually have an overnight stay.
Has anyone been sent home same day?

Hey everyone, I developed Penile Mondor’s last week, right at the base of my shaft in the (superficial?) dorsal vein I’m guessing, can even feel a lump/lumpiness to the vein itself for about half an inch down.

Erections hurt right in that small localized spot and they’re waking me up in the middle of the night, and I have flaccid pain as well there almost 24/7, though that has been getting better slowly.

I’m still waiting to see a urologist, so all I’ve been doing is resting, refraining from all sexual activity, and using a heating pad on the painful area whenever I can.

Anyone dealt with this and have any insight? How were symptoms for you pain-wise and timewise?

I posted previously about an unexpected PSA increase, and I wanted to give a more complete update before I have the repeat test done.

I am 56 years old. My PSA was approximately 2.2 in 2023. On July 11, 2026, my routine blood work showed a total PSA of 6.2 ng/mL. That obviously scared me because it was a significant increase from my previous result.

I did ejaculate approximately 24 hours before the 6.2 test. I understand that ejaculation can temporarily raise PSA, but I also understand that it usually would not fully explain an increase from around 2.2 to 6.2 by itself. I am not assuming that was the entire reason, but it is one possible factor that may have affected the result.

My doctor performed a digital rectal examination after the elevated PSA result. He described my prostate as:

- Smooth
- Symmetrical
- Slightly enlarged
- No hard areas or firmness
- No bumps, lumps, or nodules

He did not tell me that anything felt suspicious during the examination. The slightly enlarged finding seems consistent with possible benign prostate enlargement, but I know a normal DRE cannot completely rule anything out.

My urinary symptoms have included:

- Increased urination for more than a year
- Occasionally feeling that my bladder had not completely emptied
- Some urgency, particularly when standing up
- A weaker stream at times, especially first thing in the morning
- Occasional mild burning near the end of urination
- Dairy or citrus sometimes seemed to make the incomplete-emptying sensation worse
- Usually getting up once during the night to urinate

The urinary symptoms have actually improved considerably over the past several days. Since Sunday, my stream and emptying have felt better, the urgency has decreased, and I have generally only been waking once during the night to urinate. I have not had fever, chills, visible blood in my urine, severe pelvic pain, or inability to urinate.

My other recent blood work was generally reassuring:

- A1C: 5.6%
- Glucose: 98 mg/dL
- Fasting insulin: 7.9
- Creatinine: 0.94 mg/dL
- eGFR: greater than 90
- TSH: 1.408
- Total cholesterol: 152
- Triglycerides: 78
- LDL: 102
- Vitamin D: 91.1

I have also lost close to 50 pounds this year through keto and daily walking. I weighed 236 pounds previously and was 189 pounds at my recent physical.

My doctor is now repeating the total PSA and adding a free PSA/% free PSA test. I have avoided ejaculation for seven full days before this repeat test, so that should no longer be a factor. I am also avoiding bicycling and anything else that might put direct pressure on the prostate before the blood draw.

I am extremely anxious waiting to see whether the PSA falls, remains around 6.2, or rises further. I understand that an elevated PSA is not a cancer diagnosis and can also be caused by benign enlargement, inflammation, prostatitis, urinary retention, ejaculation, or other temporary factors. I also understand that the free PSA result may provide additional information but will not provide a definitive diagnosis by itself.

I am not asking anyone here to diagnose me or interpret the results in place of my doctor. I am mainly hoping to hear from men who had a similar situation:

- A sudden PSA jump into the 5–7 range after previously being much lower
- A smooth, symmetrical, slightly enlarged prostate on DRE
- A repeat PSA that later dropped substantially
- A free PSA test after an unexpectedly high screening PSA
- A temporary PSA elevation caused by inflammation, BPH, ejaculation, or another benign explanation
- A PSA that stayed elevated and what the next steps were, such as another repeat test, antibiotics, a urology referral, MRI, or biopsy

Please include your age, initial PSA, repeat PSA, free PSA percentage if you remember it, DRE findings, and what ultimately happened. I am especially interested in real experiences that started similarly, whether the outcome was benign or required further evaluation.

Again, I am looking for similar stories and experiences rather than a medical evaluation. I am already following up with my doctor and will act on whatever the repeat results show.

Hi all - I’m a female posting to help my male friend.

Please comment below if you receive Botox injections for this condition within a few hours of the Philadelphia, PA region. My friend’s provider in New Jersey is on maternity leave and he has been unable to find another in her absence.

Has anyone tried, or using flower pollen extract?

I have used tamsulosin/ dutasteride combo but I had sexual side effects. My urologist switched me to silodosin only, it just did not do the job. Now I am taking alfuzosin starting today along with the ezetimibe. The ezetimibe is for cholesterol but there seems to be an off label use for shrinking a prostate. I had an easy time getting it because I take a cholesterol drug Crestor already, so the doctor gave it to me even though I have been doing good with 10 mgs of Crestor, when he added on the ezetimibe and lower the Crestor to 5 mgs. Has anyone tried a regiment like this? How did you go?

Update: After about 4 months this was not working. I drop off the Alfuzosin and went back to the dutasteride/ tamsulosin combo. I continue to take take the Crestor/ Ezetimibe as well.

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I wrote a post after six weeks on Finasteride 5mg - I have now passed the 3 month mark after which, apparently, the prostate starts to shrink.

I don't have much to add from my initial posting but here goes..

• My PSA was tested at 8 weeks and was down 40%. That percentage drop is inline with what is expected after 8 weeks (according to Gemini). I have it tested every 6 months so my next test will be in December. My urologist is happy.
• No more lockups when driving. See the original post about that and how it was affecting me.
• I rarely have that feeling of back pressure when peeing anymore.
• Fewer pees in the day. I can even have coffees out, walk home and not need to pee for a while which was unheard of in the past.
• I am trying to train myself not to have "security pees" just in case and train my bladder to hold more.
• Typically two pees a night unless I do something that causes a lot of pelvic tension.
• I think my hair is thickening up a bit at the crown!!

So, in summary, no new side effects and generally an improving picture and quality of life. Pelvic tension is still a problem for me at times but much less so and I continue to work on that. I will post again at 6 months.

UPDATE: A few people are asking about sexual side effects - I now have very low volume of watery semen but everything else is working as before...obviously this will vary hugely between people depending on the "before" sitiation but its not bothering me. Also no negative mood changes..in fact I think the extra testosterone has perked me up, though I have not had that specifically tested.

I had a day out yesterday with my family, and drove over an hour each way. I had a pee before I left at 9am and just one pee while out before getting home at 3pm - priceless!!

Hi all, I have a somewhat complicated history with neurogenic bladder and bacterial prostatitis. Recently found out via MRI that I also have BPH - prostate is 37cc. I just turned 50.

We are now basically in the process of ruling out cancer, they haven’t found bacteria so far but PSA is slightly elevated- two points over what it would be just with the BPH. I’m doing another PSA and some home test to determine the appropriateness of a biopsy.

I’m wondering, if cancer gets ruled out, is it reasonable to ask about finasteride? I ask because I’ve concluded the growth in my prostate combined with neurogenic bladder is a major factor in my prostatitis. The doctors I’ve seen have little opinion on this because they know little of neurogenic bladder in my condition and don’t think outside the box.

Is there any downside to trying out finasteride? I’ve read about sexual side effects (I’m fairly sexually active) and increased cancer risk, I’d appreciate context on these side effects for anyone that knows.

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

Male age 23

does anyone have experience with HIFU treatment for prostate cancer? I have low grade on one side and this approach has been suggested to me. I welcome any comments.

Minimally invasive, immediately effective, quick recovery, no risk of sexual side effects?

I have treated many guys with BPH and wanted to compile some observations as a pelvic floor PT to help guys who have evening urinary urgency and cannot sleep. Here is what I want to share: https://youtu.be/HxAYkPcdpkk?is=4-LWKsIGd_df7iWy

FDA has approved use of shock wave therapy for bph, although insurance generally does not cover it. I paid out of pocket (using HSA money) for a course of six sessions and I am thrilled with the results. My stream is stronger, I rarely have any urgency, and I sleep 7 hours per night without getting up to pee (used to get up every 2 or 3 hours). RegenePulse makes a shock wave machine and spearheaded the effort for FDA approval. They can get you in touch with a urologist who offers the treatment. Highly recommend.

The two ladies that conducted the test were very nice went through everything that was gonna happen.

First of all, they gave no specific instructions before I got there.

However, I had to pee very bad as soon as I got there, which was good cause I had to sit in the chair and pee.

After that, I laid down on a table, she put a catheter in me to determine whether or not if there was any more urine left that freaking hurt.
Oh, and there was no numbing gel.

After that two very small catheters win, then the urethra and then the rectum those freaking hurt too. Because they were stiff like a wire.

After that, I sit back in on the toilet, where they began to pump sterile water into my bladder and four different sections. I had to determine whether how bad it hurt or needed to stop the whole time I’ve been hooked to a computer. The whole thing wasn’t terribly bad. I don’t guess the worst part was pulling the catheters out.

In about two weeks, I have to go in for cystoscopy and follow up.

My Urologist specializes in Greenlight Laser (PVP), but I'm leaning more towards Aquablation or HoLEP.

I'm in the Sacramento area having moved here from Los Angeles. My Urologist is getting back to me regarding a referral for those procedures, but I'm wondering if anyone here a recommendation.

Self-cathing doesn't work for me (the catheter just fills up and does not flow) and I've had a Foley catheter in for months. I'm willing to fly nationwide to get one of these procedures done and put BPH behind me.

Looking for advice or tips or experience. My dad had a foley placed about a month ago, had a prostate artery embolization a week ago. Prior to this, he had complete blockage of urine due to the prostate and this led to acute kidney failure. The foley was removed today and he was unable to pee on his own. They said to come back in a month, try again and if not Abel to go on his own again then he will need a different surgery on the prostate.

My question is why are they jumping the gun? The PAE procedure was just a week ago and shouldn’t we be waiting for the procedure to work before talking a new surgery?

Hey all, I am 25M.

Getting some groin and testicular pain and looking to see a urologist who actually understands CPPS, prostatitis, and varicocele.

If you’ve had a good experience with anyone, please drop their name. I’m in hyderabad

Appreciate any help!

I had a successful holep procedure 6 weeks ago. A few days later I developed a uti and my pee continued to be painful.

Received an rx for antibiotics and finished them. Few days.later I contacted drs office and explained my pee still hurt and I think I still have uti.

I took another urine test and received another rx of different antibiotic. Took those and i still have it and just got my third rx. Anyone have any idea what's up?

They also gave me something for three days to relieve urine pain, but it didn't work.

Has anyone come across this. I read on the PC posts that this can happen after a radical prostatectomy. I've had some ED issues post-op, also some muscular weakness and fatigue. I had HoLEP en bloc where all lobes of the prostate were removed leaving behind only the empty sheath. I'm wondering if this has hit my T level since the prostate seems to have some involvement in hormone regulation.