Urologists: You don’t want to be a regular customer!

I already had a urologist.  I had a vasectomy back in 2005.  I had another in early 2008.  Yup, I was very fertile, so I needed two.  I guess they don’t always work.  My first one was a Vasclip procedure.  It was marketed as being less painful, with a quicker recovery, fewer side effects and similar success rate.  In my case, it was all true, except for the often overlooked success rate part.  The second vasectomy was less pleasant overall than the first one, but at least it worked!  Vasclip is no longer in business, but my urologist is.

Anyway, I consulted him again in November of  2008 on my physician’s advice.  He did another urine test, another blood test and another DRE.  The results were essentially the same.  DRE showed a slightly enlarged, but otherwise normal prostate.  Trace of blood in the urine.  PSA level (using their lab) was 2.7.  They also measured something called “Free PSA”.  My level was 19.3%.  Over 25% is usually considered low risk for prostate cancer.  Under 10% is considered a warning flag for prostate cancer.  My level was in between, so it didn’t add much information.  What I did learn was that a PSA level of 2.4, 2.5 or 2.7 is not normal for someone in their 40s.  While a level of 4.0 is a standard level of further action for people in their 50s or 60s, my level should have been under 2.5, and the vast majority of people my age have a PSA level under 1.0 ng/mL.

What I also learned is that the trace of blood in the urine could be related to the prostate, but it could also be related to other problems in the urinary system.  Kidney stones, kidney tumors and bladder cancer were mentioned, among other possibilities.  I’ll go into that in a future blog, but suffice to say these possibilities have mostly been ruled out at this point.  For the time being, I’m still going on a moderately high PSA level and a slightly enlarged prostate.  I also heard the word “biopsy” for the first time.  I’ll be honest, that scared me a bit, though the urologist treated it as an everyday sort of thing.

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