Pubic/Groin Pain with Chronic Prostatitis

I'm a 62 year old male who has had CPPS/Chronic Prostatitis (CP) since I was in my early 30's. In April my PSA was 5.5 (up from 2.1 two years ago) but it was a finger stick test, I had run over 3 miles the morning before the test, and I was experiencing the worst flare-up of my CPPS in years. I tried to explain that to a urologist I went to see but was pretty much ignored. Anyway, to top it off they did a DRE (it was normal) 30 minutes before my retest. My retested PSA came back 3.1 but they still recommend a biopsy since it was above 3.0! I have read many studies of how a DRE should be done before the blood draw (can raise PSA 0.6) and also how a CP flare-up can elevate PSA (at least 1.0). So, I'm figuring my PSA is still in the 2 range once things calm down. My urologist seems very eager to put 12 holes in a prostate that is already inflamed while my family doc is saying wait a couple of months and retest. Just wanted to get everyone's opinion on that and to make everyone aware of what running or other vigorous exercise may do to your PSA number. Also, I've started having alternating pain on both sides of my pubic/groin area. I have had hernias repaired on both sides and the pain feels just like it did right after the hernia surgeries. Anyone ever experience this with CPPS/CS or prostate cancer? Sorry for the long post and thanks in advance for your responses.

[jmurgia]

As an alternative to the biopsy, you could get a Power Color Doppler scan. It cannot be used to diagnose PC, but can be used to show changes in the prostate. I understand your desire to "tread lightly". I had both a color doppler and biopsy at the same time in 2003.

Joe

[Hidden in reply to jmurgia]

I've never heard of that. I'll ask my urologist if it's available. Thanks!

[Hugo40]

I've got my first referral by my GP to a UROLOGIST, booked for WEDS 12th June.

I was supposed to go for a PSA Blood test next day after the Prostate Finger Examination. I read your post the night before and decided to put the blood test of until 5 days after the Finger examination.

So I thank you for that reminder. I had read that the Blood sample for PSA test should not take place so soon after the Finger Exam or after sexual activity, a couple years ago but had forgotten. I asked a question on method of Biopsy in a post "The Pincushion Biopsy" but got no replies just yet. Must not be a popular subject. I have 2 colleagues that had horrific infections caused by the Pincushion Biopsy. I know it's crude but cost effective. That's the least of my concerns, the cost.

Hugo40

[CaptainA1]

I had a very similar experience five years ago and elected for three monthly monitoring of my PSA rather than the biopsy which I considered an unnecessary risk. If my PSA starts to rise significantly (doubling) I will get a high resolution scan prior to having a biopsy. Best wishes.

[Hidden in reply to CaptainA1]

Just had my PSA checked again and it was exactly the same...3.1, so still not sure exactly what is going on. At least it didn't go up anymore. I still have some symptoms of my recent flare-up going on but they seem to be fading. Did you have the groin pain also? Thanks for the reply!

[CaptainA1 in reply to Hidden]

No groin pain as such - just a bit of discomfort and difficulty emptying. My psa has been hovering around 5.

[Hidden]

Thanks for the reply...right now things seem to be getting back to close to normal. Still a little groin pain and I've noticed my stream is a little weaker, but I've been cutting back on fluids before bed which may be causing that. I just had my PSA checked a week ago and it's still 3.1 so not going up at this point. I'm thinking of waiting a couple of months and check it again.

[Raymo69]

I just saw your post & would like to help if I can. Any Dr. worth their weight would never perform a DRE right before a PSA test. You’re 100% correct stating that it will upset your prostate enough to release more antigens. So will sex, riding a bike, jogging, inflammation, etc. etc. Wait about three days doing none of the above before you get your next PSA test. As far as imaging & biopsy, try to find a hospital or cancer center that has a 3-T MRI machine, preferably a place that will do an MRI guided biopsy. This will give them a great image of what’s going on & avoid taking unnecessary needles into healthy tissue. Before I knew about any of this I was talked into a “blind” 12 core biopsy. It put me in the hospital for a week with a bad case of sepsis. Wasn’t fun. I had just turned 45 at the time too.

[Hidden in reply to Raymo69]

I'm looking for a urologist who has access to the 3T MRI but not having much luck. I have called several places but they are very reluctant to speak to someone without a referral and if they are going to pay out of pocket. I've read a lot of posts about guys who have had the 3T scans but must be qualified for medicare,,,which seems to pay this bill. Thanks for the response and I hope you are doing fine!

[Raymo69 in reply to Hidden]

I’ve had many 3-T scans covered under BCBS Illinois. Hope you can find it. Good luck to you

[Hidden in reply to Raymo69]

That's great to hear because I have Ohio BCBS. If you don't mind me asking what was your situation? Initial biopsy or repeat? PSA level? Any other circumstances that may have prompted them to cover it? My urologist said he doubted insurance would cover it because my PSA was lower at 3.1 but I do have chronic prostatitis, have symptoms or flare up, and have a family history of prostate cancer.

[Raymo69 in reply to Hidden]

Well having BCBS is good to hear despite what what your urologist told you because I’ve never been turned down & I've had many. I will admit that my situation is a lot worse though. I don’t mind sharing but don’t want to scare anyone. First psa was taken at age 44. Came back at 3.6. Was told I “should probably “ see a urologist. I had zero symptoms. This was done because my father passed fairly young with kidney cancer & I was kinda hard on my Dr. about what he was doing about making sure the same thing didn’t happen to me. He mentioned I was a bit young but he’d check for PSA, the only other test he could think of as the other bloodwork always came back perfect. FFW 1 year. 2nd PSA was taken just after my 45th Birthday. Came back 5.9. Was asked what the urologist said & I admitted I never went. This time I did & did my first 12 core biopsy. Results came back as Gleason 8 (4+4). At that age every Dr. I saw was telling me to get surgery. After reading about the side effects &’the fact that surgery doesn’t necessarily “cure” cancer for everyone, I opted for the Focal Laser Ablation. Probably a mistake looking back but this was new back then & I was a willing “Guinea pig” of sorts. I tried this three times. Just didn’t work for me. Now, five years later at age 50, my last PSA was 15. After many many different opinions from many many Drs. I realized we’re running out of time here. I’ve been on Lupron for about 6 weeks now & just started radiation treatments two days ago. Both my current Drs. told me it’s actually a good thing I didn’t get that surgery because I’d be one of those patients that would have to come back & do exactly what I’m doing now.

So that’s a very short version of my story over five years but please don’t let any of this scare you. My next door neighbors PSA is over 6, has had multiple biopsies but they can’t find any cancer at all. He’s around 70 years old & had the same issue you have. BPH, inflammation etc. But no cancer. I’d have to check but at your age with your conditions, any PSA reading under 4 is considered “normal”. That said, PSA is not a great test to detect cancer. It only detects the presence of the antigen given off the prostate. BPH, inflammation etc. WILL cause your PSA to rise. So does simple aging. You seem to be in a much better situation than I so I wish you only the best & hoping you don’t even have cancer.

As a side note, I’ve fired several Drs. that make excuses. Don’t be afraid to fire yours. A pet scan was ordered for me before I started my latest treatments & was initially denied. Drs. nurse called BCBS directly & got it approved. If your Dr. isn’t willing to do this for you find one that will. My results of the PET scan came back negative for metastatic disease thank God, so I think I’m in good hands with the current team & current treatments.

Again, I wish you all the best!

Ray

[Hidden in reply to Raymo69]

Hi Ray,,,just saw your reply,,,sorry I didn't respond faster. Very glad to hear everything is negative for you,,,that is always good news. Thanks for the advice and encouragement too! I deeply appreciate it. I am going to dump my current urologist and go with another one. Trouble is it takes 2 months to get into see one. But that will give me a chance to monitor my PSA a while longer before I make any decisions and hopefully find one that believes in MP MRI first before the needle biopsy. Take care!

[Mrtroxely]

I watched video on pmsa pet scans, this and Dr scholtz sayThat pmsa pet scan 'could' avoid prostate biopsy and give better view of exactly what's going on

Think you guys in America are having that as option when diagnosing

(No such luck in UK.....)