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What causes slow stream urination with a family history of prostate cancer?

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Posted on Sat, 28 May 2016
Question: Hi

I am 42 male and i have been experiencing interrupted/slow stream of urination the first thing in the morning, I notice if i sit down i need push hard to get it to start and it sometime slows to a stop. But if i am standing up I can pee pretty much normally without any slow stream or needing to push hard. The problem with urinating sitting down only happens first thing in the morning on my first toilet visit. The rest of the day/evening it is fine I can pee normally standing up or sitting down.

Other observations: I don't need to get up in the middle of the night to go - i sleep through it. I don't experience frequent urination, no sudden urge to go, no uncontrolled urination, i don't have the feeling of unable to empty the bladder, or any pain or blood. I notice sometimes i have a few drips after urination but if i pay attention and leave it a bit longer before i pull up my trousers I am OK. I have performed self check - digital exam many times (once every few months) of the prostate gland and felt nothing unusual - i feel a smooth arch/indent/flat area of about 4cm in diameter.

Family history - my father was diagnosed with prostate cancer at the age of 65-66. Should i be concerned and have my prostate investigated ie PSA test etc?

Thank you
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Answered by Dr. Matthew J. Mangat (32 minutes later)
Brief Answer:
A thorough evaluation is needed.

Detailed Answer:
Hello XXXXX and welcome to HCM.
As an Urologist, i can fully understand your concern.

It's good that you're aware of prostate gland enlargement.
Incidence of hereditary prostate cancers are between 5-10%.

Understand that self examination,can never diagnose prostate gland cancer.
You must get examined by an Urologist.
Only he can do, a proper digital rectal examination.(DRE).

Your description of difficulty in passing urine, in squatting position,is suggestive of some difficulty in urinary passage.

The following tests are needed to give expert advice :
1. urine routine and culture.
2. blood routine, creatinine,PSA, RBS,platelets and LFT.
3. Urine flow rate.
4. ultrasound scan, with residual urine.

According to these reports,an expert opinion for curing your problem can be given.
Wish you well.

Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1898 Questions

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What causes slow stream urination with a family history of prostate cancer?

Brief Answer: A thorough evaluation is needed. Detailed Answer: Hello XXXXX and welcome to HCM. As an Urologist, i can fully understand your concern. It's good that you're aware of prostate gland enlargement. Incidence of hereditary prostate cancers are between 5-10%. Understand that self examination,can never diagnose prostate gland cancer. You must get examined by an Urologist. Only he can do, a proper digital rectal examination.(DRE). Your description of difficulty in passing urine, in squatting position,is suggestive of some difficulty in urinary passage. The following tests are needed to give expert advice : 1. urine routine and culture. 2. blood routine, creatinine,PSA, RBS,platelets and LFT. 3. Urine flow rate. 4. ultrasound scan, with residual urine. According to these reports,an expert opinion for curing your problem can be given. Wish you well. Dr.Matthew J. Mangat.