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What does my ultrasound scan report indicate?

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Posted on Wed, 20 Jul 2016
Question: Hi,
I had an elevated PSA of 2.3 so was recommended for a transrectal ultrasound. I received the ultrasound report as follows:

A history of elevated PSA of 2.3 is noted.

There is grade 2 enlargement of the prostate, measuring 4.9cm craniocaudal x 3.4cm AP x 5.5cm transverse in its maximum dimensions, giving a volume about 49 ml. The prostate parenchyma has a slightly heterogeneous decreased echotexture and there was moderate increased blood flow demonstrated in the prostate parenchyma, indicating presence of prostatitis. In addition, there is prominent calcification noted at the left posterior aspect of the prostate from previous prostatitis. No neoplastic lesion demonstrated in the prostate, especially at both peripheral zones. Both seminal vesicles appear normal.

Conclusion:
Grade 2 enlargement of the prostate with a volume of 49ml. There is heterogenous decreased echogenicity of the prostate parenchymal with increased blood flow, suggestive of prostatitis, and there is also calcification in the prostate from previous prostatitis. No neoplastic lesion demonstrated.


So far I have just seen my GP who said the prostate's normal size is 2.5cm. Is my prostate significantly enlarged? I have been prescribed Macrodantin 30 capsules with another 30 if needed. I am not sure why I should take antibiotics as infection isn't definitely the cause. I have just read that Macrodantin can have serious side-effects and is sometimes fatal. Should I take this antibiotic or wait for further evaluation for cause? What tests might be useful to suggest cause? I have constipation and think it may have caused the prostatitis.

I have been suggested regular follow-up with the same transrectal ultrasound procedure, is this necessary? Could an MRI also determine size of the prostate?


Thanks,
Regards,
xxxxxxx
doctor
Answered by Dr. Matthew J. Mangat (2 hours later)
Brief Answer:
PSA upto 4 is normal.

Detailed Answer:
Hi XXXXXXX and welcome to HCM.
As an Urologist,i can understand your concern.

A PSA of 2.3 is not abnormal. Normal limit is upto 4.
With increased size of prostate gland,as in your case,the PSA also increases.
It also increases in cases of infection.(prostatitis).

It's good you've done an ultrasound scan.
It shows that you've nothing to worry about.

Repeat the PSA after one year.
A scan is done,only if you've urinary symptoms or high PSA,above 4.

Hope your doubts are cleared.
Wish you well.

Dr.Matthew J. Mangat.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (42 hours later)
Thanks Dr. Mangat,

Did the ultrasound show a prostate which is dangerously enlarged or does it only become a problem when it causes symptoms like painful or difficult urination?

Should I try the Macrodantin treatment or is the prostatitis possibly not caused by infection and could have another cause?


Thanks,
Regards.
doctor
Answered by Dr. Matthew J. Mangat (25 minutes later)
Brief Answer:
Macrodantin is used in treatment for prostatitis.

Detailed Answer:
Hello XXXXXXX

The prostate gland which's symptomatic is operated.
Large glands or glands which cause retention of urine,are also operated.
After failure of medical treatment as well,patient's are operated.

So,you've to decide about medical or surgical treatment.
Prostatitis has not been confirmed in your case.

The scan shows an enlarged prostate gland,which's not dangerous by any means.
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 does my ultrasound scan report indicate?

Brief Answer: PSA upto 4 is normal. Detailed Answer: Hi XXXXXXX and welcome to HCM. As an Urologist,i can understand your concern. A PSA of 2.3 is not abnormal. Normal limit is upto 4. With increased size of prostate gland,as in your case,the PSA also increases. It also increases in cases of infection.(prostatitis). It's good you've done an ultrasound scan. It shows that you've nothing to worry about. Repeat the PSA after one year. A scan is done,only if you've urinary symptoms or high PSA,above 4. Hope your doubts are cleared. Wish you well. Dr.Matthew J. Mangat.